University of Florida College of Medicine-Jacksonville, Jacksonville, Florida 32209, USA.
J Am Coll Cardiol. 2010 Nov 16;56(21):1683-92. doi: 10.1016/j.jacc.2010.04.063.
Antithrombotic therapy represents the mainstay of treatment for prevention of recurrent ischemic events in patients with atherothrombotic disease processes. Although the benefits of antithrombotic pharmacotherapy in the elderly are well established, the elderly are generally more vulnerable to the adverse effects of antithrombotic drugs. Such higher vulnerability may be related to distinct pharmacokinetic and pharmacodynamic responses in the late age of life, during which drug-drug interactions due to polypharmacy further enhance the risk of adverse effects associated with the use of antithrombotic agents. Given that the prevalence of atherothrombotic disease, as well as diseases with thromboembolic potential, increases exponentially with age and that the elderly population is in continuous growth, understanding strategies of antithrombotic management in these patients is of key importance. The present paper provides an overview of the current available evidence on the use of antithrombotic therapy in elderly patients with the primary focus on treatment of coronary artery disease.
抗血栓治疗是预防动脉粥样硬化血栓形成疾病患者复发缺血事件的主要治疗方法。虽然抗血栓药物治疗在老年人中的益处已得到充分证实，但老年人通常更容易受到抗血栓药物不良反应的影响。这种更高的脆弱性可能与生命后期独特的药代动力学和药效学反应有关，在此期间，由于多种药物治疗导致的药物相互作用进一步增加了与使用抗血栓药物相关的不良反应风险。鉴于动脉粥样硬化血栓形成疾病以及具有血栓栓塞风险的疾病的患病率随年龄呈指数级增长，并且老年人口不断增长，了解这些患者的抗血栓治疗管理策略至关重要。本文概述了目前关于老年患者抗血栓治疗的现有证据，主要侧重于治疗冠状动脉疾病。
