Featured Research

from universities, journals, and other organizations

Don't be afraid: very old patients treated with Vitamin K antagonists, if adequately managed, benefit from anticoagulation

Date:
August 29, 2011
Source:
European Society of Cardiology
Summary:
Results of the EPICA Study (Elderly Patients followed by Italian Centers for Anticoagulation Study), were presented at the ESC Congress 2011 today. This is the largest study on very old patients anti-coagulated with vitamin K antagonists for the prevention of venous thromboembolism and, for the major part (75 percent), for the prevention of stroke because affected by atrial fibrillation.

Results of the EPICA Study (Elderly Patients followed by Italian Centres for Anticoagulation Study), were presented at the ESC Congress 2011. This is the largest study on very old patients anticoagulated with Vitamin K antagonists for the prevention of venous thromboembolism and, for the major part (75%), for the prevention of stroke because affected by atrial fibrillation.

Related Articles


All studied patients started the anticoagulant treatment after the age of 80 years, and the median age of studied patients was 84 years, ranging from 80 to 102 years. Fear of bleeding is the major concern for Vitamin K antagonist prescription, in particular in very old patients who carry many risk factors for bleeding. This study demonstrates a low rate of bleeding complications, notwithstanding the particularly advanced age of the patients, suggesting that age in itself should not be considered a contraindication to this treatment.

The prevalence of atrial fibrillation is strongly dependent on age and is present in nearly 10% of subjects after the age of 80 years. Given the aging of the population in western countries, the number of individuals with AF is likely to increase substantially in the next few years. Atrial fibrillation increases the risk of stroke 4 -5-fold, across all age groups, and it is estimated that the percentage of stroke attributable to atrial fibrillation rose up to 23.5% in the age group of 80 to 89 year-olds.

In the EPICA study, all patients were followed-up for anticoagulation management by specifically devoted Centres and showed a good quality of anticoagulation. Centres in this study, routinely practiced patient education, including explaining the purposes of treatment, risk of complications and information about laboratory controls.

"Actually, we know that well informed patients carry a lower risk for adverse events during anticoagulant treatment. Family members and care givers are also involved in the education programme. Due to the variable effect of oral anticoagulants that is present among the individuals and over time also for the single subject, patients receive a detailed prescription of daily dosages and the indication for the subsequent visits. The good management of anticoagulation probably explains the low bleeding risk recorded in this study," explained Dr Daniela Poli, from Thrombosis Centre AOU Careggi Firenze -Italy.

The EPICA study shows that the use of the 'old' Vitamin K antagonists is beneficial for very old people. "This is interesting especially now, because we are waiting for the 'new' oral anticoagulant drugs, that will be marketed in Europe in the next few months. No information is available at the moment for their use in very old people. In addition, it should be noted that renal failure is one of the main risk factors for bleeding and our study outlined also that the major part of very old patients have a severe or moderate renal insufficiency, that is known to get worse with age. Unlike 'old' anticoagulants, the 'new' ones have a prevalent renal route of excretion and are contraindicated in renal failure. Therefore, a large group of old patients should be carefully monitored over time to detect worsening of renal function that not infrequently happens for intercurrent illnesses, such as infection or heart failure," said Dr Poli.

This large study on very old patients on VKA treatment, showed that the rate of bleeding complications was low, suggesting that age in itself should not be considered a contraindication to treatment. An adequate management of VKA therapy with the careful monitoring of patients, in specifically trained Centres, allows very old and frail patients to benefit from VKA thromboprophylaxis.


Story Source:

The above story is based on materials provided by European Society of Cardiology. Note: Materials may be edited for content and length.


Cite This Page:

European Society of Cardiology. "Don't be afraid: very old patients treated with Vitamin K antagonists, if adequately managed, benefit from anticoagulation." ScienceDaily. ScienceDaily, 29 August 2011. <www.sciencedaily.com/releases/2011/08/110829114026.htm>.
European Society of Cardiology. (2011, August 29). Don't be afraid: very old patients treated with Vitamin K antagonists, if adequately managed, benefit from anticoagulation. ScienceDaily. Retrieved November 28, 2014 from www.sciencedaily.com/releases/2011/08/110829114026.htm
European Society of Cardiology. "Don't be afraid: very old patients treated with Vitamin K antagonists, if adequately managed, benefit from anticoagulation." ScienceDaily. www.sciencedaily.com/releases/2011/08/110829114026.htm (accessed November 28, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, November 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Rural India's Low-Cost Sanitary Pad Revolution

Rural India's Low-Cost Sanitary Pad Revolution

AFP (Nov. 28, 2014) — One man hopes his invention -– a machine that produces cheap sanitary pads –- will help empower Indian women. Duration: 01:51 Video provided by AFP
Powered by NewsLook.com
Research on Bats Could Help Develop Drugs Against Ebola

Research on Bats Could Help Develop Drugs Against Ebola

AFP (Nov. 28, 2014) — In Africa's only biosafety level 4 laboratory, scientists have been carrying out experiments on bats to understand how virus like Ebola are being transmitted, and how some of them resist to it. Duration: 01:18 Video provided by AFP
Powered by NewsLook.com
WHO Says Male Ebola Survivors Should Abstain From Sex

WHO Says Male Ebola Survivors Should Abstain From Sex

Newsy (Nov. 28, 2014) — WHO cites four studies that say Ebola can still be detected in semen up to 82 days after the onset of symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins