Purpose: The frequency of pathologies requiring anticoagulant treatment (thromboembolic disease, atrial fibrillation) is particularly high in people above 75. The risk of haemorrhagic complications is also highest in this population of patients.Therefore, the assessment of the risk/benefit ratio of an anticoagulant treatment may overestimate the haemorrhagic risk and lead to the under-using of anticoagulant treatment in such pathologies as atrial fibrillation. CURRENT KNOWLEDGE AND KEY-POINTS: However, the use of "classical" anticoagulant treatments such as non-fractionated heparin, low-molecular-weight heparin, and above all, antivitamin K requires special precautions. Several hemorrhagic risk factors are well known and should be spotted out. Finally, the risk/benefit ratio of an anticoagulant treatment in the elderly patients must rely on a comprehensive geriatric assessment.
Prospects And Projects: In the era of "new anticoagulant treatments", and particularly of per-os antithrombin, it may seem anachronous to issue a statement over the use of "classical anticoagulant treatments", but in the present state of knowledge, the evaluation of these new molecules is not sufficient in the elderly population of patients.
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http://dx.doi.org/10.1016/j.revmed.2005.10.006 | DOI Listing |
Future Cardiol
January 2025
Department of Cardiovascular Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves. These options each have unique benefits and risks profiles.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Erasmus University Medical Center, Rotterdam, Zuid-Holland, Netherlands.
Background: Treatment with monoclonal antibodies against amyloid-β slowed cognitive decline in recent randomized clinical trials in patients with mild cognitive impairment (MCI) and early dementia due to Alzheimer's disease (AD). However, trial eligibility criteria may affect generalizability to clinical practice.
Methods: We extracted eligibility criteria for trials of aducanumab, lecanemab and donanemab from published reports, and applied these to participants with MCI and early clinical AD dementia from the population-based Rotterdam Study.
Eur Stroke J
January 2025
Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Introduction: The efficacy and safety of statins for secondary prevention in patients who have experienced a cardioembolic stroke are not well-defined. However, previous observational data reported hyperlipidemia as a risk factor for both ischemic and bleeding complications in patients with AF and previous stroke. Based on these premises, we conducted a sub-analysis of the RAF and RAF-NOAC studies to evaluate the efficacy and safety of statins in secondary prevention in patients with acute ischemic stroke and AF.
View Article and Find Full Text PDFAnaesthesia
January 2025
Department of Anaesthesia, Derriford Hospital, Plymouth, UK and the Defence Anaesthesia Representative.
Background: The administration of blood components and their alternatives can be lifesaving. Anaemia, bleeding and transfusion are all associated with poor peri-operative outcomes. Considerable changes in the approaches to optimal use of blood components and their alternatives, driven by the findings of large randomised controlled trials and improved haemovigilance, have become apparent over the past decade.
View Article and Find Full Text PDFCrit Care Resusc
December 2024
Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.
Objectives: The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.
Design: retrospective, binational registry-based cohort study and electronic survey of clinical practice.
Setting: ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.
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