Does ageing reduce warfarin dose requirements in patients on long-term therapy for thromboembolic disease prophylaxis?
Warfarin dose requirements decrease significantly with age, suggesting a need for gradual dose reduction and careful monitoring in older patients on long-term therapy.
This longitudinal study was designed to establish the rate of age-related change in warfarin dose requirements. Warfarin dosage was recorded retrospectively in 104 patients who had been stabilized on warfarin for a median period of 10 years (range 6-24 years) for prophylaxis of thromboembolic disease. There was a significant negative correlation between dosage and age at the start of therapy (p = 0.002, r = -0.30). Warfarin requirements fell over time, dosage difference being significantly correlated with age difference (p = 0.01, r = 0.25). Use of regression equation derived from these data suggests a 21% fall in warfarin requirements in this population over a 15-year period. The relationship between change in warfarin dose requirements and ageing established in this longitudinal study is in good agreement with that established by cross-sectional studies, suggesting that no major birth cohort effect is influencing requirements in our warfarin-treated population.
Wynne et al. (1996) studied this question.