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[Antithrombotic therapy in the elderly patient]

J C de Sousa1, C Duarte, F Carriço

  • 1Instituto de Trombose e Hemostase, Hospital de Santa Maria, Lisboa, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|March 1, 1997
PubMed
Summary

Antithrombotic therapy, including anticoagulants and antiplatelet agents, is crucial for preventing cardiocirculatory and cerebrovascular diseases in the elderly. This review details optimal dosing, therapeutic induction, and management of complications for these vital treatments.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Cardiovascular Medicine

Context:

  • Cardiovascular and cerebrovascular diseases are leading causes of death in Portugal, particularly among the elderly.
  • Antithrombotic therapies are essential for managing these conditions in older populations.

Purpose:

  • To provide a comprehensive review of antithrombotic therapies in the elderly, focusing on oral anticoagulants, heparin, and antiplatelet agents.
  • To discuss current recommendations, therapeutic challenges, and complication management for these treatments.

Summary:

  • Oral anticoagulant therapy recommendations for atrial fibrillation now suggest lower INR levels, with exceptions for mechanical prosthetic valves.
  • Heparin therapy review covers standard vs. low molecular weight heparins, addressing side effects like hemorrhage and osteoporosis in the elderly.

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  • Antiplatelet therapy, particularly aspirin at lower effective doses (75-150 mg/day), is discussed for primary prevention in high-vascular-risk elderly patients, with considerations for individual patient needs.

    • Impact:

    • This review offers practical guidance for clinicians on optimizing antithrombotic therapy in elderly patients.
    • It highlights the importance of individualized treatment approaches to minimize risks and maximize benefits of antithrombotic medications.