Oral anticoagulation treatment in the elderly: A nested, prospective, case-control study

Gualtiero Palareti, Jack Hirsh, Cristina Legnani, Cesare Manotti, Armando D'Angelo, Vittorio Pengo, Marco Moia, Giuliana Guazzaloca, Serena Musolesi, Sergio Coccheri

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Whether elderly patients are at increased risk of complications during oral anticoagulant treatment (OAT) is still a matter of debate. Method: Bleeding and thrombotic events occurring during OAT in 461 patients, aged 75 years or older when they started OAT, and in 461 patients younger than 70 years, matched for sex, OAT indication, and treating center, were examined in a prospective, multicenter, inception-cohort study. Results: Bleeding rate was 9.9% and 6.6% patient-years in elderly and young patients, respectively (P = .07), and 2.1% and 1.1% for major bleeding (P = .19); 6 and 1 events, respectively, were fatal (all intracranial, relative risk, 6.4; P = .05). In the elderly, bleeding rate was lower (4.5%) for international normalized ratios (INRs) between 2.0 and 2.9; it was higher during the first 90 treatment days (P = .05) and when arterial vascular disease was the indication for OAT (P = .03). Thrombosis rate was 4.2% and 2.5% patient-years in elderly and young patients, respectively (P = .10); however, 13 and 5 events were fatal (relative risk, 2.8; P = .04). Thrombosis rate was lower (1.5%) for INRs between 2.0 and 219: it was higher during the first 90 treatment days (P

Original languageEnglish
Pages (from-to)470-478
Number of pages9
JournalArchives of Internal Medicine
Volume160
Issue number4
Publication statusPublished - Feb 28 2000

ASJC Scopus subject areas

  • Internal Medicine

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