Aspects of anticoagulant therapy in venous thromboembolism, pulmonary embolism. Focus on elderly patients

Abstract

The prevalence and mortality due to venous thromboembolism (VTE) occupies a leading position among the population throughout the world. The incidence and severity of VTE increases the older the patient. The emergence of a new group of direct oral anticoagulants significant changed the management of these groups of patients. The article touches upon the problem of choice, efficacy and safety of oral anticoagulants in elderly and senile patients with VTE, in particular in pulmonary embolism (PE). An analysis of randomized clinical trials and prospective cohort studies is given. In addition, rational recommendations are given on the optimal choice of oral anticoagulant in these categories of patients. Apixaban and rivaroxaban are highly effective drugs of choice with a reliable safety profile in patients of the senile age group in the prevention and treatment of VTE, including PE, and apixaban has the most optimal profile and safety class among all other oral anticoagulants when used in elderly and senile patients.