Extended Antithrombotic Therapy in Elderly Patients with Deep Venous Thrombosis

Abstract

Objective. The objective of the present study was to evaluate the quality of the extended anticoagulation in elderly patients with a history of deep vein thrombosis. Material and methods. We examined and treated 50 women with deep venous thrombosis in the inferior vena cava system. The mean age was 72.8±6.08 age. The study group included 24 people taking rivaroxaban as secondary prevention of recurrent venous thrombosis (mean age 72.7±5.7). The control group included 26 patients taking vitamin K antagonist warfarin (mean age 72.9±6.5). Evaluation criteria were the frequency of recurrence of deep venous thrombosis and bleeding complications. Results. There was 3 episodes of recurrent deep venous thrombosis in the control group (11.5%) and no episodes in the basic group taking rivaroxaban (p=0.235). The number of haemorrhagic complications in the control group was 46.2% (n=12) and found to be higher than in the group taking rivaroxaban (20.8%, n=5), but not statistically significant (p=0.077). The number of patients at the age of 75—89 years who had haemorrhagic complications was higher in the control group comparing to group taking rivaroxaban (p=0.04). Doctors of clinics in a residence of patients have not managed to provide the adequate INR therapeutic range. Conclusion. Administration of rivaroxaban in elderly patients is efficient in prevention of recurrent deep venous thrombosis. Use of vitamin K antagonists is associated with certain difficulties, in particular carrying out adequate control of the anticoagulation therapy and further adjustments that in turn can lead to development of haemorrhagic complications or recurrent deep venous thrombosis.