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Acute, periprocedural and longterm antithrombotic therapy in older adults

2023-01-21Journal article Open access
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dc.contributor.authorAndreotti, Felicita
dc.contributor.authorGeisler, Tobias
dc.contributor.authorCollet, Jean-Philippe
dc.contributor.authorGigante, Bruna
dc.contributor.authorGorog, Diana A
dc.contributor.authorHalvorsen, Sigrun
dc.contributor.authorLip, Gregory Y H
dc.contributor.authorMorais, João
dc.contributor.authorNavarese, Eliano Pio
dc.contributor.authorPatrono, Carlo
dc.contributor.authorRocca, Bianca
dc.contributor.authorRubboli, Andrea
dc.contributor.authorSibbing, Dirk
dc.contributor.authorStorey, Robert F
dc.contributor.authorVerheugt, Freek W A
dc.contributor.authorVilahur, Gemma
dc.date.accessioned2023-12-18T17:59:00Z
dc.date.available2023-12-18T17:59:00Z
dc.date.issued2023-01-21
dc.description.abstractThe 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAndreotti, 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.pt_PT
dc.identifier.doihttps://doi.org/10.1093/eurheartj/ehac515pt_PT
dc.identifier.eissn1522-9645
dc.identifier.issn0195-668X
dc.identifier.urihttp://hdl.handle.net/10400.8/9106
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Press; European Society of Cardiologypt_PT
dc.relation.ispartofseries4;
dc.relation.publisherversionhttps://academic.oup.com/eurheartj/article/44/4/262/6881548pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectElderlypt_PT
dc.subjectAntiplateletpt_PT
dc.subjectAnticoagulantpt_PT
dc.subjectCoronary syndromespt_PT
dc.subjectAtrial fibrillationpt_PT
dc.subjectSurgerypt_PT
dc.subjectTAVIpt_PT
dc.subjectLAACpt_PT
dc.titleAcute, periprocedural and longterm antithrombotic therapy in older adultspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage279pt_PT
oaire.citation.startPage262pt_PT
oaire.citation.titleEuropean Heart Journalpt_PT
oaire.citation.volume44pt_PT
person.familyNameMorais
person.givenNameJoão
person.identifier.ciencia-id3614-652A-118E
person.identifier.orcid0000-0003-3406-2878
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication3bc0f910-a460-461f-863a-1ca701ee597f
relation.isAuthorOfPublication.latestForDiscovery3bc0f910-a460-461f-863a-1ca701ee597f

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