Antikoagulační léčba ve stáří
| Title in English | Anticoagulation therapy in the elderly |
|---|---|
| Authors | |
| Year of publication | 2018 |
| Type | Article in Periodical |
| Magazine / Source | Interní medicína pro praxi |
| MU Faculty or unit | |
| Citation | |
| Keywords | Anticoagulation therapy; New peroral anticoagulation drugs; Venous tromboembolism; Vitamin K antagonists |
| Description | Elderly patients with atrial fibrillation (AF) and venous tromboembolism (VTE) are at elevated risk of thromboembolic events and bleeding compared to younger patients. The most common reason for withholding anticoagulation in older patients is a perception of a high risk of falling and associated bleeding, especially intracranial hemorrhage. Assessing the benefit-risk ratio of anticoagulation is one of the most challenging issues in the individual elderly patient, patients at highest hemorrhagic risk often being those who would have the greatest benefit from anticoagulants. Some specific considerations are important when using anticoagulants in the elderly to maximize safety of these treatments, including decreased renal function, co-morbidities and risk of falls, altered pharmacodynamics and concomitant medications. Novel oral anticoagulants (NOACs) have recently emerged as alternatives to Vitamin K Antagonists (VKAs) and could simplify the management and increase the safety of anticoagulaton due to fewer drug/food interactions, rapid onset/offset of action and ease of use, without routine monitoring necessary. Recent studies and meta-analyses have shown that their efficacy and safety are largely preserved in older patients. |