Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Antithrombotic drugs for older subjects - Guidelines formulated jointly bythe Italian Societies of Haemostasis and Thrombosis (SISET) and of Gerontology and Geriatrics (SIGG)
Autore:
Di Minno, G; Tufano, A; Cerbone, AM;
Indirizzi:
Univ Naples, Policlin Federico II, Dipartimento Med Clin & Sperimentale, Cattedra Gerontol & Geriatr, I-80131 Naples, Italy Univ Naples Naples Italy I-80131 rontol & Geriatr, I-80131 Naples, Italy
Titolo Testata:
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
fascicolo: 1, volume: 11, anno: 2001,
pagine: 41 - 62
SICI:
0939-4753(200102)11:1<41:ADFOS->2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEEP-VEIN THROMBOSIS; LOW-MOLECULAR-WEIGHT; ACUTE MYOCARDIAL-INFARCTION; LOW-DOSE HEPARIN; TOTAL HIP-REPLACEMENT; CONTINUOUS INTRAVENOUS HEPARIN; NONRHEUMATIC ATRIAL-FIBRILLATION; ACUTE VENOUS THROMBOEMBOLISM; MASSIVE PULMONARY-EMBOLISM; AMERICAN-HEART-ASSOCIATION;
Keywords:
elderly; antiplatelet agents; anticoagulation; thrombolytic agents;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
143
Recensione:
Indirizzi per estratti:
Indirizzo: Tufano, A Univ Naples, Policlin Federico II, Dipartimento Med Clin & Sperimentale, Cattedra Gerontol & Geriatr, Via S Pansini 5, I-80131 Naples, Italy Univ Naples Via S Pansini 5 Naples Italy I-80131 Naples, Italy
Citazione:
G. Di Minno et al., "Antithrombotic drugs for older subjects - Guidelines formulated jointly bythe Italian Societies of Haemostasis and Thrombosis (SISET) and of Gerontology and Geriatrics (SIGG)", NUTR MET CA, 11(1), 2001, pp. 41-62

Abstract

Older individuals contribute heavily to the percentage of deaths due to myocardial infarction (MI) and stroke. The incidence of venous thromboembolism (VTE) is highest in subjects > 65 years. Prospective intervention trials involving groups of clinically comparable subjects > 60 allow the followingstatements to be made with regard to the use of antithrombotic drugs in the elderly. Antiplatelet agents. To prevent recurrence of ischaemic stroke and MI in stable/unstable angina, MI, TIA/stroke or peripheral arterial disease, aspirin is the drug of choice. Clopidogrel is more effective than aspirin in this respect. Heparin. For the treatment of acute deep venous thrombosis (DVT) and pulmonary embolism, (PE), intravenous standard heparin or subcutaneous standard heparin are effective (aPTT 1.5-2.0 times baseline values). As the risk of bleeding increases with age, low-molecular-weight heparins (LMWH) are preferable in the elderly. For the prophylaxis of VTE in general surgery in subjects at low-moderate risk, low-dose heparin or low doses of LMWH are effective. In subjects at high risk, adjusted-dose heparin plus physical devices or high-dose LMWH arerecommended. The combination of heparin and aspirin is the standard treatment for unstable angina and non-Q wave MI. LMWH are as active as standard heparin in this indication. Vitamin K antagonists. For the chronic treatment of VTE, warfarin is also the treatment of choice (INR 2.0-3.0) in the elderly, though lower doses are needed due to their hypersensitivity to oral anticoagulants. For the prevention of thromboembolic stroke in patients > 75 with atrial fibrillation, warfarin is the drug of choice. Patients aged 65-75 may receive warfarin oraspirin. Thrombolytic agents. Thrombolytic agents are not recommended for treating DVT in the elderly because of their limited risk/benefit ratio and should be confined to massive PE. In the absence of contraindications, thrombolysisfor MI may be considered in the elderly. (C) 2001, Medikal Press.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 12:43:54