PMID- 19503778
OWN - NLM
STAT- MEDLINE
DCOM- 20100407
LR  - 20211020
IS  - 1178-1998 (Electronic)
IS  - 1176-9092 (Print)
IS  - 1176-9092 (Linking)
VI  - 4
IP  - 
DP  - 2009
TI  - Use of anticoagulants in elderly patients: practical recommendations.
PG  - 165-77
AB  - Elderly people represent a patient population at high thromboembolic risk, but 
      also at high hemorrhagic risk. There is a general tendency among physicians to 
      underuse anticoagulants in the elderly, probably both because of underestimation 
      of thromboembolic risk and overestimation of bleeding risk. The main indications 
      for anticoagulation are venous thromboembolism (VTE) prophylaxis in medical and 
      surgical settings, VTE treatment, atrial fibrillation (AF) and valvular heart 
      disease. Available anticoagulants for VTE prophylaxis and initial treatment of 
      VTE are low molecular weight heparins (LMWH), unfractionated heparin (UFH) or 
      synthetic anti-factor Xa pentasaccharide fondaparinux. For long-term 
      anticoagulation vitamin K antagonists (VKA) are the first choice and only 
      available oral anticoagulants nowadays. Assessing the benefit-risk ratio of 
      anticoagulation is one of the most challenging issues in the individual elderly 
      patient, patients at highest hemorrhagic risk often being those who would have 
      the greatest benefit from anticoagulants. Some specific considerations are of 
      utmost importance when using anticoagulants in the elderly to maximize safety of 
      these treatments, including decreased renal function, co-morbidities and risk of 
      falls, altered pharmacodynamics of anticoagulants especially VKAs, association 
      with antiplatelet agents, patient education. Newer anticoagulants that are 
      currently under study could simplify the management and increase the safety of 
      anticoagulation in the future.
FAU - Robert-Ebadi, Helia
AU  - Robert-Ebadi H
AD  - Division of Angiology and Hemostasis, Department of Internal Medicine, Geneva 
      University Hospital and Faculty of Medicine, Geneva, Switzerland. 
      helia.robert-ebadi@hcuge.ch
FAU - Le Gal, Gregoire
AU  - Le Gal G
FAU - Righini, Marc
AU  - Righini M
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090514
PL  - New Zealand
TA  - Clin Interv Aging
JT  - Clinical interventions in aging
JID - 101273480
RN  - 0 (Anticoagulants)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Accidental Falls
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/pharmacokinetics/pharmacology/*therapeutic use
MH  - Atrial Fibrillation/drug therapy
MH  - Factor Xa
MH  - Female
MH  - Heart Valve Diseases/drug therapy
MH  - Hemorrhagic Disorders/etiology
MH  - Humans
MH  - Male
MH  - Renal Insufficiency/chemically induced
MH  - Risk Assessment
MH  - Venous Thromboembolism/prevention & control
PMC - PMC2685237
OTO - NOTNLM
OT  - anticoagulation
OT  - atrial fibrillation
OT  - elderly patients
OT  - factor Xa inhibitor
OT  - hemorrhagic risk
OT  - thrombin inhibitors
OT  - venous thromboembolism
EDAT- 2009/06/09 09:00
MHDA- 2010/04/08 06:00
PMCR- 2009/05/14
CRDT- 2009/06/09 09:00
PHST- 2009/06/09 09:00 [entrez]
PHST- 2009/06/09 09:00 [pubmed]
PHST- 2010/04/08 06:00 [medline]
PHST- 2009/05/14 00:00 [pmc-release]
AID - cia-4-165 [pii]
AID - 10.2147/cia.s4308 [doi]
PST - ppublish
SO  - Clin Interv Aging. 2009;4():165-77. doi: 10.2147/cia.s4308. Epub 2009 May 14.