Anticoagulant therapy in elderly patients

Abstract

The pathology of recent years is dominated by lung thromboembolism, the more worrying factor as the algorithms for prophylaxis and treatment of diseases with high embolic risk are properly applied in medical practice and perform only of 75% antithrombotic protection. The aim is to present the benefits and risks of anticoagulant treatment in elderly patients with cardiovascular disease. Anticoagulant treatment is at least as important as for the other age groups because elderly patients have combinations of cardiovascular diseases and comorbidity which have anticoagulant treatment indications. We performed a retrospective study on 781 patients over 65 years, admitted between January 1, 2009 and March 31, 2010 in Medical Clinic IV, Department of Geriatrics. Statistical study followed their distribution by age, average residence, gender, cardiovascular diseases, anti-coagulant treatment indication and methods of implementation. From 781 patients, 758 cases (97%) were hospitalized for cardiovascular disease of these, 545 (72%) received anticoagulant therapy, 152 (20%) received also antiplatelet and 61 (8%) did not receive any of these forms. Adverse effects of anticoagulation therapy were recorded at 1.5% of patients. All these patients were under chronic anticoagulation therapy with antivitamin К and required permanent or temporary interruption. Anticoagulant therapy in the elderly is under-utilized due to fear of unwanted side effects taking into consideration the problems of monitoring chronic treatment with К antivitamin at home.