title: Venous thromboembolism in centenarians: Findings from the RIETE registry.
abstract: BACKGROUND
  The balance between the efficacy and safety of anticoagulant therapy in patients aged ≥100years receiving anticoagulant therapy for venous thromboembolism (VTE) is uncertain.
  
  
  METHODS
  We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the rate of VTE recurrences, bleeding events, and mortality appearing during the course of anticoagulant therapy in VTE patients aged ≥100years.
  
  
  RESULTS
  Of 61,173 patients enrolled in RIETE as of January 2016, 47 (0.08%) were aged ≥100years. Of these, 10 (21%) were men, 21 (45%) presented with pulmonary embolism (PE), and 26 with deep vein thrombosis alone. Overall, 35 patients (74%) had severe renal insufficiency, 14 (30%) chronic heart failure, 30 (64%) anemia, 16 (34%) were taking antiplatelets, and 6 (13%) corticosteroids or non-steroidal anti-inflammatory drugs. Most patients (95%) were treated initially with low-molecular-weight heparin (LMWH) (mean daily dose, 168±42IU/kg). Then, 14 (30%) switched to vitamin K antagonists and 29 (62%) kept receiving long-term LMWH therapy (mean, 148±51IU/kg/day). During the course of anticoagulant therapy (mean duration, 139days), mortality was high (15/47; 32%). Two patients died of PE (initial PE one, recurrent PE one) and 5 (11%) had minor bleeding, but no major bleeding was reported.
  
  
  CONCLUSIONS
  Among patients with acute VTE aged ≥100years, the risk of VTE recurrences during the course of anticoagulation outweighed the risk of bleeding. Our data suggest the use of standard anticoagulant therapy in this patient population, even if they have severe renal insufficiency.
authors: Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Navarra, Spain.
authors: Beatriz
authors: B
authors: Lacruz
authors: Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Navarra, Spain.
authors: Gregorio
authors: G
authors: Tiberio
authors: Department of Internal Medicine, Complejo Hospitalario de Pontevedra, Pontevedra, Spain.
authors: Manuel Jesús
authors: MJ
authors: Núñez
authors: Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors: Luciano
authors: L
authors: López-Jiménez
authors: Department of Internal Medicine, Hospital Universitario de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors: Antoni
authors: A
authors: Riera-Mestre
authors: Department of Haemostasis and Thrombosis, Ospedale Infermi, Rimini, Italy.
authors: Eros
authors: E
authors: Tiraferri
authors: Vascular Medicine and Haemostasis, University of Leuven, Leuven, Belgium.
authors: Peter
authors: P
authors: Verhamme
authors: Department of Angiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors: Lucia
authors: L
authors: Mazzolai
authors: Department of Internal Medicine, ALTHAIA, Xarxa Assistencial de Manresa, Barcelona, Spain.
authors: José
authors: J
authors: González
authors: Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Barcelona, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.
authors: Manuel
authors: M
authors: Monreal
mesh_terms: D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology; D000925:Anticoagulants / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006470:Hemorrhage / Q000139:chemically induced*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000453:epidemiology; D012008:Recurrence; D012042:Registries; D051437:Renal Insufficiency / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000453:epidemiology; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000453:epidemiology; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin
keywords: Anticoagulants; Centenarians; Outcome; Venous thromboembolism