Use of anticoagulants in elderly patients: practical recommendations. - Université de Bretagne Occidentale Access content directly
Journal Articles Clin Interv Aging Year : 2009

Use of anticoagulants in elderly patients: practical recommendations.


Elderly people represent a patient population at high thromboembolic risk, but also at high hemorrhagic risk. There is a general tendency among physicians to underuse anticoagulants in the elderly, probably both because of underestimation of thromboembolic risk and overestimation of bleeding risk. The main indications for anticoagulation are venous thromboembolism (VTE) prophylaxis in medical and surgical settings, VTE treatment, atrial fibrillation (AF) and valvular heart disease. Available anticoagulants for VTE prophylaxis and initial treatment of VTE are low molecular weight heparins (LMWH), unfractionated heparin (UFH) or synthetic anti-factor Xa pentasaccharide fondaparinux. For long-term anticoagulation vitamin K antagonists (VKA) are the first choice and only available oral anticoagulants nowadays. 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 of utmost importance when using anticoagulants in the elderly to maximize safety of these treatments, including decreased renal function, co-morbidities and risk of falls, altered pharmacodynamics of anticoagulants especially VKAs, association with antiplatelet agents, patient education. Newer anticoagulants that are currently under study could simplify the management and increase the safety of anticoagulation in the future.
No file

Dates and versions

hal-00683243 , version 1 (28-03-2012)


  • HAL Id : hal-00683243 , version 1
  • PUBMED : 19503778


Helia Robert-Ebadi, Grégoire Le Gal, Marc Righini. Use of anticoagulants in elderly patients: practical recommendations.. Clin Interv Aging, 2009, 4, pp.165-77. ⟨hal-00683243⟩
32 View
0 Download



Gmail Mastodon Facebook X LinkedIn More