Anticoagulation in the Older Adult: Optimizing Benefit and Reducing Risk

Darae Ko; Elaine M. Hylek

doi:10.1055/s-0034-1389083

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2014; 40(06): 688-694
DOI: 10.1055/s-0034-1389083

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anticoagulation in the Older Adult: Optimizing Benefit and Reducing Risk

Darae Ko

¹Department of Medicine, Boston University School of Medicine, Boston, Massachusetts

,

Elaine M. Hylek

¹Department of Medicine, Boston University School of Medicine, Boston, Massachusetts

› Author Affiliations

Abstract

The risk for both arterial and venous thrombosis increases with age. Despite the increasing burden of strokes related to atrial fibrillation (AF) and venous thromboembolism (VTE) among older adults, the use of anticoagulant therapy is limited in this population due to the parallel increase in risk of serious hemorrhage. Understanding the risks and their underlying mechanisms would help to mitigate adverse events and improve persistence with these life-saving therapies. The objectives of this review are to: (1) elucidate the age-related physiologic changes that render this high risk subgroup susceptible to hemorrhage, (2) identify mutable risk factors and hazards contributing to an increased bleeding risk in older individuals, and (3) discuss interventions to optimize anticoagulation therapy in this population.

Keywords

aging - anticoagulation - warfarin - atrial fibrillation - stroke - venous thromboembolism

Full Text

References

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