This review highlights the importance of specific management, education, and monitoring to minimize hemorrhagic risk in elderly patients (≥75 years) treated with VKAs for VTE or NVAF.
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Supports tailored VKA monitoring in elderly VTE/NVAF patients; leaves open optimal protocols via prospective trials.
As the population ages, the number of patients aged 75 years and over treated with vitamin K antagonists (VKAs) is steadily increasing. In this age group, the two main indications for oral anticoagulant therapy are the treatment of venous thromboembolic disease and the prevention of systemic embolism in patients with nonvalvular atrial fibrillation. In both indications, a target international normalized ratio of 2.5 (range: 2.0-3.0) is recommended. Although VKAs are beneficial in thromboembolic disorders, they are still underused. In this review, we will focus on two crucial topics in elderly patients, the specific management of VKAs in these patients and the hemorrhagic risk. Current recommendations concerning the management at the start of treatment, education and adequate monitoring may help to minimize the hemorrhagic risk in these frail patients.
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Siguret et al. (2007) studied this question.
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