Key result
Five clinical cases outline safe anticoagulant management strategies for older patients with AF or VTE.
Why the study?
Anticoagulants are underused, often underdosed, or subject to poor adherence in older patients with atrial fibrillation or venous thromboembolism due to bleeding concerns and complex risks.
How should anticoagulant therapy be managed in older individuals with atrial fibrillation or venous thromboembolism?
How should anticoagulant therapy be managed in older individuals with atrial fibrillation or venous thromboembolism?
This review provides practical, case-based approaches to managing anticoagulant therapy in older patients with atrial fibrillation or venous thromboembolism, addressing common challenges like bleeding risk and polypharmacy.
Answers are grounded in this paper and cite their sources.
Case-based illustrations support individualized anticoagulation strategies in older AF/VTE patients; leaves open need for prospective trials.
Anticoagulant therapy is the most effective strategy to prevent arterial and venous thromboembolism, but treating older individuals is challenging, because increasing age, comorbidities, and polypharmacy increase the risk of both thrombosis and bleeding. Warfarin and non-vitamin K antagonist oral anticoagulants are underused and often underdosed in the prevention of stroke in older patients with atrial fibrillation because of concerns about the risk of bleeding. Poor adherence to anticoagulant therapy is also an issue for older patients with atrial fibrillation and those at risk of recurrent pulmonary embolism. In this review, we present 5 clinical cases to illustrate common challenges with anticoagulant use in older patients and discuss our approach to institute safe and effective antithrombotic therapy.
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Chan et al. (2019) conducted a review in Atrial fibrillation or venous thromboembolism (n=5). Anticoagulant therapy was evaluated. Anticoagulant therapy management in older patients with atrial fibrillation or venous thromboembolism is illustrated through 5 clinical cases discussing approaches for safe and effective treatment.
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