[Use of anticoagulant treatments in the elderly].
OBJECTIVE
The frequency of pathologies requiring anticoagulant treatment (thromboembolic disease, atrial fibrillation) is particularly high in people above 75. The risk of haemorrhagic complications is also highest in this population of patients.Therefore, the assessment of the risk/benefit ratio of an anticoagulant treatment may overestimate the haemorrhagic risk and lead to the under-using of anticoagulant treatment in such pathologies as atrial fibrillation. CURRENT KNOWLEDGE AND KEY-POINTS: However, the use of "classical" anticoagulant treatments such as non-fractionated heparin, low-molecular-weight heparin, and above all, antivitamin K requires special precautions. Several hemorrhagic risk factors are well known and should be spotted out. Finally, the risk/benefit ratio of an anticoagulant treatment in the elderly patients must rely on a comprehensive geriatric assessment.


CONCLUSIONS
In the era of "new anticoagulant treatments", and particularly of per-os antithrombin, it may seem anachronous to issue a statement over the use of "classical anticoagulant treatments", but in the present state of knowledge, the evaluation of these new molecules is not sufficient in the elderly population of patients.
Gentric
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A
Service de médecine interne gériatrique, CHU de La Cavale-Blanche, 29285, Brest cedex, France. armelle.gentric@chu-brest.fr
Estivin
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S
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015577:Geriatric Assessment; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000188:drug therapy*; D016896:Treatment Outcome; D014812:Vitamin K / Q000009:adverse effects / Q000037:antagonists & inhibitors*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014812:Vitamin K; D006493:Heparin