Abstract
Arterial and venous thromboembolism are both more common in older adults. The use of anticoagulants, the mainstay to prevent thromboembolism, requires consideration of the balance between risk and benefit. Such consideration is even more important in the very elderly in whom the risk of anticoagulant-related bleeding and thrombosis are higher. This review will focus on the challenges of implementing and managing anticoagulant therapy in older patients in an era when the options for anticoagulants include not only vitamin K antagonists (VKAs), but also direct-acting oral anticoagulants (DOACs).
Highlights
Arterial and venous thromboembolism are both more common in older adults
The risk reduction (RR) in stroke and systemic embolism was similar (P-interaction = 0.38) in patients ≥75 years old (RR 0.78; 95% confidence interval (CI): 0.66–0.88) and in those
Both arterial and venous thromboembolism are more common in older adults, but so is the risk of anticoagulant-related bleeding
Summary
Arterial and venous thromboembolism are both more common in older adults. The use of anticoagulants, the mainstay to prevent thromboembolism, requires consideration of the balance between risk and benefit. Such consideration is even more important in the very elderly in whom the risk of anticoagulant-related bleeding and thrombosis are higher. This review will focus on the challenges of implementing and managing anticoagulant therapy in older patients in an era when the options for anticoagulants include vitamin K antagonists (VKAs), and direct-acting oral anticoagulants (DOACs). Reviewed by: Danuza Esquenazi, Oswaldo Cruz Foundation (Fiocruz), Brazil Paolo Prandoni, Arianna Foundation on Anticoagulation, Italy. Specialty section: This article was submitted to Geriatric Medicine, a section of the journal
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