Acute, periprocedural and longterm antithrombotic therapy in older adults
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.8/9106 |
Resumo: | The first international guidance on antithrombotic therapy in the elderly came from the European Society of Cardiology Working Group on Thrombosis in 2015. This same group has updated its previous report on antiplatelet and anticoagulant drugs for older patients with acute or chronic coronary syndromes, atrial fibrillation, or undergoing surgery or procedures typical of the elderly (transcatheter aortic valve implantation and left atrial appendage closure). The aim is to provide a succinct but comprehensive tool for readers to understand the bases of antithrombotic therapy in older patients, despite the complexities of comorbidities, comedications and uncertain ischaemic- vs. bleeding-risk balance. Fourteen updated consensus statements integrate recent trial data and other evidence, with a focus on high bleeding risk. Guideline recommendations, when present, are highlighted, as well as gaps in evidence. Key consensus points include efforts to improve medical adherence through deprescribing and polypill use; adoption of universal risk definitions for bleeding, myocardial infarction, stroke and cause-specific death; multiple bleeding-avoidance strategies, ranging from gastroprotection with aspirin use to selection of antithrombotic-drug composition, dosing and duration tailored to multiple variables (setting, history, overall risk, age, weight, renal function, comedications, procedures) that need special consideration when managing older adults. © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. |
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Acute, periprocedural and longterm antithrombotic therapy in older adultsElderlyAntiplateletAnticoagulantCoronary syndromesAtrial fibrillationSurgeryTAVILAACThe first international guidance on antithrombotic therapy in the elderly came from the European Society of Cardiology Working Group on Thrombosis in 2015. This same group has updated its previous report on antiplatelet and anticoagulant drugs for older patients with acute or chronic coronary syndromes, atrial fibrillation, or undergoing surgery or procedures typical of the elderly (transcatheter aortic valve implantation and left atrial appendage closure). The aim is to provide a succinct but comprehensive tool for readers to understand the bases of antithrombotic therapy in older patients, despite the complexities of comorbidities, comedications and uncertain ischaemic- vs. bleeding-risk balance. Fourteen updated consensus statements integrate recent trial data and other evidence, with a focus on high bleeding risk. Guideline recommendations, when present, are highlighted, as well as gaps in evidence. Key consensus points include efforts to improve medical adherence through deprescribing and polypill use; adoption of universal risk definitions for bleeding, myocardial infarction, stroke and cause-specific death; multiple bleeding-avoidance strategies, ranging from gastroprotection with aspirin use to selection of antithrombotic-drug composition, dosing and duration tailored to multiple variables (setting, history, overall risk, age, weight, renal function, comedications, procedures) that need special consideration when managing older adults. © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved.Oxford University Press; European Society of CardiologyIC-OnlineAndreotti, FelicitaGeisler, TobiasCollet, Jean-PhilippeGigante, BrunaGorog, Diana AHalvorsen, SigrunLip, Gregory Y HMorais, JoãoNavarese, Eliano PioPatrono, CarloRocca, BiancaRubboli, AndreaSibbing, DirkStorey, Robert FVerheugt, Freek W AVilahur, Gemma2023-12-18T17:59:00Z2023-01-212023-01-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.8/9106engAndreotti, F., Geisler, T., Collet, J. P., Gigante, B., Gorog, D. A., Halvorsen, S., ... & Vilahur, G. (2023). Acute, periprocedural and longterm antithrombotic therapy in older adults: 2022 Update by the ESC Working Group on Thrombosis. European Heart Journal, 44(4), 262-279.0195-668Xhttps://doi.org/10.1093/eurheartj/ehac5151522-9645info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-17T15:58:52Zoai:iconline.ipleiria.pt:10400.8/9106Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:51:41.775232Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
title |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
spellingShingle |
Acute, periprocedural and longterm antithrombotic therapy in older adults Andreotti, Felicita Elderly Antiplatelet Anticoagulant Coronary syndromes Atrial fibrillation Surgery TAVI LAAC |
title_short |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
title_full |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
title_fullStr |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
title_full_unstemmed |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
title_sort |
Acute, periprocedural and longterm antithrombotic therapy in older adults |
author |
Andreotti, Felicita |
author_facet |
Andreotti, Felicita Geisler, Tobias Collet, Jean-Philippe Gigante, Bruna Gorog, Diana A Halvorsen, Sigrun Lip, Gregory Y H Morais, João Navarese, Eliano Pio Patrono, Carlo Rocca, Bianca Rubboli, Andrea Sibbing, Dirk Storey, Robert F Verheugt, Freek W A Vilahur, Gemma |
author_role |
author |
author2 |
Geisler, Tobias Collet, Jean-Philippe Gigante, Bruna Gorog, Diana A Halvorsen, Sigrun Lip, Gregory Y H Morais, João Navarese, Eliano Pio Patrono, Carlo Rocca, Bianca Rubboli, Andrea Sibbing, Dirk Storey, Robert F Verheugt, Freek W A Vilahur, Gemma |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
IC-Online |
dc.contributor.author.fl_str_mv |
Andreotti, Felicita Geisler, Tobias Collet, Jean-Philippe Gigante, Bruna Gorog, Diana A Halvorsen, Sigrun Lip, Gregory Y H Morais, João Navarese, Eliano Pio Patrono, Carlo Rocca, Bianca Rubboli, Andrea Sibbing, Dirk Storey, Robert F Verheugt, Freek W A Vilahur, Gemma |
dc.subject.por.fl_str_mv |
Elderly Antiplatelet Anticoagulant Coronary syndromes Atrial fibrillation Surgery TAVI LAAC |
topic |
Elderly Antiplatelet Anticoagulant Coronary syndromes Atrial fibrillation Surgery TAVI LAAC |
description |
The first international guidance on antithrombotic therapy in the elderly came from the European Society of Cardiology Working Group on Thrombosis in 2015. This same group has updated its previous report on antiplatelet and anticoagulant drugs for older patients with acute or chronic coronary syndromes, atrial fibrillation, or undergoing surgery or procedures typical of the elderly (transcatheter aortic valve implantation and left atrial appendage closure). The aim is to provide a succinct but comprehensive tool for readers to understand the bases of antithrombotic therapy in older patients, despite the complexities of comorbidities, comedications and uncertain ischaemic- vs. bleeding-risk balance. Fourteen updated consensus statements integrate recent trial data and other evidence, with a focus on high bleeding risk. Guideline recommendations, when present, are highlighted, as well as gaps in evidence. Key consensus points include efforts to improve medical adherence through deprescribing and polypill use; adoption of universal risk definitions for bleeding, myocardial infarction, stroke and cause-specific death; multiple bleeding-avoidance strategies, ranging from gastroprotection with aspirin use to selection of antithrombotic-drug composition, dosing and duration tailored to multiple variables (setting, history, overall risk, age, weight, renal function, comedications, procedures) that need special consideration when managing older adults. © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-12-18T17:59:00Z 2023-01-21 2023-01-21T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.8/9106 |
url |
http://hdl.handle.net/10400.8/9106 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Andreotti, F., Geisler, T., Collet, J. P., Gigante, B., Gorog, D. A., Halvorsen, S., ... & Vilahur, G. (2023). Acute, periprocedural and longterm antithrombotic therapy in older adults: 2022 Update by the ESC Working Group on Thrombosis. European Heart Journal, 44(4), 262-279. 0195-668X https://doi.org/10.1093/eurheartj/ehac515 1522-9645 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press; European Society of Cardiology |
publisher.none.fl_str_mv |
Oxford University Press; European Society of Cardiology |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137008087465984 |