Thrombotic events are a major cause of morbidity in the elderly and are a growing concern in the medical community as the population ages. A shift to a procoagulant state occurs with aging, and aging itself is a risk factor for arterial and venous thrombosis. Unfractionated heparin (UFH) is a heterogeneous mixture of glycosaminoglycans that binds to antithrombin via a pentasaccharide, and catalyzes the inactivation of thrombin and other clotting factors. Different factors affect drug levels and drug sensitivity in older people. Alteration in drug kinetics and toxicity, coagulation factors, and changes in body composition as well as weight due to aging can affect anticoagulant therapy. A careful evaluation of renal function and poly-pharmacotherapy appears to be mandatory before therapy with LMWH is started in older patients. UFH and low molecular weight heparin(LMWH) are as effective in older individuals as in younger ones to prevent and treat thrombosis. However, they are associated with a higher risk of bleeding in older individuals, especially in those with kidney insufficiency. © 2005 Copyright © 2005 Elsevier B.V. All rights reserved..
Use of heparin preparations in older patients / Tufano, A., Nicola Dario Di Minno, M.. - (2005), pp. 727-743. [10.1016/B978-008044859-6/50027-7]
Use of heparin preparations in older patients
Tufano A.;Nicola Dario Di Minno M.
2005
Abstract
Thrombotic events are a major cause of morbidity in the elderly and are a growing concern in the medical community as the population ages. A shift to a procoagulant state occurs with aging, and aging itself is a risk factor for arterial and venous thrombosis. Unfractionated heparin (UFH) is a heterogeneous mixture of glycosaminoglycans that binds to antithrombin via a pentasaccharide, and catalyzes the inactivation of thrombin and other clotting factors. Different factors affect drug levels and drug sensitivity in older people. Alteration in drug kinetics and toxicity, coagulation factors, and changes in body composition as well as weight due to aging can affect anticoagulant therapy. A careful evaluation of renal function and poly-pharmacotherapy appears to be mandatory before therapy with LMWH is started in older patients. UFH and low molecular weight heparin(LMWH) are as effective in older individuals as in younger ones to prevent and treat thrombosis. However, they are associated with a higher risk of bleeding in older individuals, especially in those with kidney insufficiency. © 2005 Copyright © 2005 Elsevier B.V. All rights reserved..I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
