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[Safety of oral anticoagulation in aged patients with heart diseases]

M C García Garay1, F Marín Ortuño, V Roldán Schilling

  • 1Servicio de Hematología, Hospital General Universitario de Alicante.

Revista Clinica Espanola
|July 11, 1998
PubMed

Insights

Elderly patients on acenocoumarol anticoagulation showed a low rate of severe bleeding complications. Advanced age was not a contraindication for oral anticoagulant therapy in this study group.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Anticoagulation therapy in elderly patients raises concerns about increased hemorrhagic risk.
  • Hemorrhagic complications in patients over 70 receiving acenocoumarol for heart disease were investigated.

Purpose of the Study:

  • To assess the safety and efficacy of acenocoumarol anticoagulation in elderly patients.
  • To determine the incidence of hemorrhagic complications in this demographic.

Main Methods:

  • A cohort of 72 patients (mean age 73 years) on acenocoumarol therapy for one year was monitored.
  • International Normalized Ratio (INR) was measured bi-weekly, with therapeutic range defined as 2.0-4.5.

Main Results:

  • 19 patients had elevated INR (>4.5) once, and 11 had elevated INR on multiple occasions.
  • 16 patients experienced hemorrhagic complications; 5 required hospitalization but no transfusions.
  • No cases of cerebral hemorrhage or peripheral embolism were reported.

Conclusions:

  • The majority of elderly patients maintained therapeutic INR levels during acenocoumarol treatment.
  • Severe hemorrhagic complications were infrequent, suggesting good safety profile.
  • Advanced age did not appear to be a significant risk factor for adverse outcomes with oral anticoagulation.
Abstract

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