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Eur J Intern Med. 2016 Dec;36:62-66. doi: 10.1016/j.ejim.2016.07.025. Epub 2016 Aug 3.

Venous thromboembolism in centenarians: Findings from the RIETE registry.

Author information

1
Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Navarra, Spain.
2
Department of Internal Medicine, Complejo Hospitalario de Pontevedra, Pontevedra, Spain.
3
Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
4
Department of Internal Medicine, Hospital Universitario de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
5
Department of Haemostasis and Thrombosis, Ospedale Infermi, Rimini, Italy.
6
Vascular Medicine and Haemostasis, University of Leuven, Leuven, Belgium.
7
Department of Angiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
8
Department of Internal Medicine, ALTHAIA, Xarxa Assistencial de Manresa, Barcelona, Spain.
9
Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Barcelona, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.

Abstract

BACKGROUND:

The balance between the efficacy and safety of anticoagulant therapy in patients aged ≥100years receiving anticoagulant therapy for venous thromboembolism (VTE) is uncertain.

METHODS:

We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the rate of VTE recurrences, bleeding events, and mortality appearing during the course of anticoagulant therapy in VTE patients aged ≥100years.

RESULTS:

Of 61,173 patients enrolled in RIETE as of January 2016, 47 (0.08%) were aged ≥100years. Of these, 10 (21%) were men, 21 (45%) presented with pulmonary embolism (PE), and 26 with deep vein thrombosis alone. Overall, 35 patients (74%) had severe renal insufficiency, 14 (30%) chronic heart failure, 30 (64%) anemia, 16 (34%) were taking antiplatelets, and 6 (13%) corticosteroids or non-steroidal anti-inflammatory drugs. Most patients (95%) were treated initially with low-molecular-weight heparin (LMWH) (mean daily dose, 168±42IU/kg). Then, 14 (30%) switched to vitamin K antagonists and 29 (62%) kept receiving long-term LMWH therapy (mean, 148±51IU/kg/day). During the course of anticoagulant therapy (mean duration, 139days), mortality was high (15/47; 32%). Two patients died of PE (initial PE one, recurrent PE one) and 5 (11%) had minor bleeding, but no major bleeding was reported.

CONCLUSIONS:

Among patients with acute VTE aged ≥100years, the risk of VTE recurrences during the course of anticoagulation outweighed the risk of bleeding. Our data suggest the use of standard anticoagulant therapy in this patient population, even if they have severe renal insufficiency.

KEYWORDS:

Anticoagulants; Centenarians; Outcome; Venous thromboembolism

PMID:
27495947
DOI:
10.1016/j.ejim.2016.07.025
[Indexed for MEDLINE]

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