Antithrombotic Therapy in the Elderly

Antithrombotic therapy represents the mainstay of treatment for prevention of recurrent ischemic events in patients with atherothrombotic disease processes. Although the benefits of antithrombotic pharmacotherapy in the elderly are well established, the elderly are generally more vulnerable to the adverse effects of antithrombotic drugs. Such higher vulnerability may be related to distinct pharmacokinetic and pharmacodynamic responses in the late age of life, during which drug-drug interactions due to polypharmacy further enhance the risk of adverse effects associated with the use of antithrombotic agents. Given that the prevalence of atherothrombotic disease, as well as diseases with thromboembolic potential, increases exponentially with age and that the elderly population is in continuous growth, understanding strategies of antithrombotic management in these patients is of key importance. The present paper provides an overview of the current available evidence on the use of antithrombotic therapy in elderly patients with the primary focus on treatment of coronary artery disease. (J Am Coll Cardiol 2010;56:1683-92) (C) 2010 by the American College of Cardiology Foundation