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- Title
Anticoagulación oral en el adulto mayor frágil con fibrilación auricular.
- Authors
Oswaldo Cadena-Sanabria, Miguel; Mariano Pinto-Saavedra, Oscar; Fernando Contreras-Valero, Juan; Eduardo Ortega-Ramírez, Gustavo; Alexis Bautista-Mier, Heider
- Abstract
Introduction: Aging increases the risk of thrombosis and embolic phenomena. It also brings physiological changes, and comorbidities such as atrial fibrillation that makes complex the onset and safety of anti-clotting. Despite the greater availability of anti-clotting clinics and new oral anticoagulants, the percentage of elderly who are anticoagulated is low, even though they have indications and no contraindications. Objective: To review the main strategies to predict and reduce the risk of bleeding with the use of oral anti-clotting in fragile elderly patients. Methodology: A systematic search was conducted on studies evaluating the safety and efficacy of oral anticoagulants in patients with atrial fibrillation in adults older than 65 years, and a search for studies on the frailty syndrome and its impact on the elderly anticoagulated. Results and Discussion: Fragility has been termed to the percentage of elderly who were diagnosed with a greater deterioration of their biological, physical and cognitive systems, leading to a greater probability of adverse outcomes in health, disability and death. Some clinical features have been studied to identify patients as fragile; Linda Fried's frailty phenotype evaluates these characteristics; furthermore, there are strategies for monitoring oral anticoagulants that should be known to reduce the risk of adverse events. Conclusions: The frail elderly has some risk factors that are likely to affect the efficacy and safety of oral anti-clotting therapy. Existing clinical guidelines do not provide enough evidence and do not consider the elderly patient in a multidimensional manner.
- Subjects
ANTICOAGULANTS; ATRIAL fibrillation; HEALTH of older people; DRUG side effects; GERIATRICS
- Publication
MedUNAB, 2016, Vol 19, Issue 3, p221
- ISSN
0123-7047
- Publication type
Article