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 Printable version |
Anticoagulant therapy in the elderly: special considerations |
Hématologie. Volume 15, Number 3, 223-34, mai-juin 2009, Revue
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 Résumé
Article gratuit
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Author(s) : Virginie Siguret, Isabelle Gouin, Éric Pautas |
Summary : As the population ages, the number of patients older than 75 years receiving anticoagulant therapy, heparin derivatives or vitamin K antagonists, increases steadily. The use of anticoagulants in these frail elderly patients who are at high risk of bleeding and thrombosis is complicated by the comorbid conditions including renal failure, acute illnesses and polypharmacy. Until recently, only few data on the risk/benefit ratio of anticoagulant drugs were available in this group of age. However, pharmacoclinical studies, cohort studies and a few trials including elderly patients have been published last years or are still going on regarding low molecular weight heparins, fondaparinux at prophylactic or therapeutic dose and vitamin K antagonists. Special considerations on the choice of the anticoagulant drug, dosing, and monitoring have to be taken into account in this special population in order to avoid over dosage and to minimize the haemorrhagic risk which can be fatal in the elderly. New oral anticoagulants with a wider therapeutic index are awaited with a great interest. |
Keywords : anticoagulation, heparin, LMWH, fondaparinux, vitamin K antagonist, elderly |
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