Gross Peter L, Chan Noel C
Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada.
Front Med (Lausanne). 2021 Jan 27;7:470016. doi: 10.3389/fmed.2020.470016. eCollection 2020.
Arterial and venous thromboembolism are both more common in older adults. The use of anticoagulants, the mainstay to prevent thromboembolism, requires consideration of the balance between risk and benefit. Such consideration is even more important in the very elderly in whom the risk of anticoagulant-related bleeding and thrombosis are higher. This review will focus on the challenges of implementing and managing anticoagulant therapy in older patients in an era when the options for anticoagulants include not only vitamin K antagonists (VKAs), but also direct-acting oral anticoagulants (DOACs).
动脉和静脉血栓栓塞在老年人中都更为常见。使用抗凝剂作为预防血栓栓塞的主要手段,需要权衡风险与获益。在超高龄老年人中,这种权衡更为重要,因为他们发生抗凝剂相关出血和血栓形成的风险更高。在抗凝剂不仅包括维生素K拮抗剂(VKA),还包括直接口服抗凝剂(DOAC)的时代,本综述将聚焦于老年患者实施和管理抗凝治疗所面临的挑战。