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Anticoagulation in older adults

Section Editors
Lawrence LK Leung, MD
Kenneth E Schmader, MD
Deputy Editor
Jennifer S Tirnauer, MD


Most of the common cardiovascular disorders in older adults have a relationship to thrombosis, including ischemic heart disease, atrial fibrillation, valvular disease, and atherosclerotic vascular disease. Many of these patients require antithrombotic therapy, which raises questions regarding the appropriate use and safety of these agents, especially since older adults are at greater risk of anticoagulant-associated bleeding. The presence of concomitant physical and medical problems and the use of other drugs, especially the antiplatelet agents, increase the interactions and risks associated with anticoagulant therapy, requiring an assessment of the overall risk-benefit ratio [1].

Oral anticoagulation is commonly indicated in the following cardiovascular conditions:

Nonvalvular atrial fibrillation (see "Atrial fibrillation: Anticoagulant therapy to prevent embolization")

Cardioembolic stroke (see "Secondary prevention for specific causes of ischemic stroke and transient ischemic attack")

Valvular heart disease and prosthetic heart valves (see "Antithrombotic therapy for prosthetic heart valves: Indications")

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Literature review current through: Sep 2017. | This topic last updated: Mar 17, 2016.
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