 |
|
Aging and Heparin-Related Bleeding
Norman R. C. Campbell, MD;
Russell D. Hull, MBBS;
Rollin Brant, PhD;
David B. Hogan, MD;
Graham F. Pineo, MD;
Gary E. Raskob, MSc
Arch Intern Med. 1996;156(8):857-860.
Abstract
| |
Background
Many studies have suggested that elderly patients are at increased risk of bleeding during heparin therapy.
Objective
To establish whether the risk of bleeding in the elderly results from concomitant risk factors or is associated with the aging process itself.
Methods
One hundred ninety-nine patients who presented with proximal deep vein thrombosis were treated with a standard intravenous heparin protocol in a doubleblind, randomized, prospective study. Bleeding complications were monitored. Activated partial thromboplastin times and heparin levels were assessed 4 to 6 hours after a standard intravenous heparin bolus and infusion. Heparin doses and heparin levels were also assessed after stable therapeutic heparin infusion rates were established.
Results
There was an increase in total and major bleeding complications with aging (P<.05) that was not accounted for by standard risk factors for bleeding. Aging was associated with an increase in heparin levels (r=.239, P=.003) and a tendency for an increase in activated partial thromboplastin time (r=.134, P=.07) after standard heparin doses. Aging was also associated with lower heparin dose requirements (r= /p=m-/.267, P=.003) after therapeutic activated partial thromboplastin times were achieved.
Conclusion
Aging is a risk for heparin-related bleeding that may be explicable by age-related changes in the pharmacologic characteristics of heparin.
(Arch Intern Med. 1996;156:857-860)
Author Affiliations
From the Clinical Trials Unit (Drs Campbell, Hull, Brant, and Pineo and Mr Raskob), Divisions of General Internal Medicine (Dr Campbell and Hull), Geriatrics (Drs Campbell and Hogan), and Haemat Haematology y (Dr P Pineo), Departments o of Medicine (Drs Campbell, l, Hull, and Pineo and Mr Raskob), Community Health Sciences (Drs Brant and Hogan), and pharmacology and Therapeutics (Dr Campbell), Faculty of Medicine, University of Calgary (Alberta)..
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Hemorrhagic Complications of Anticoagulant and Thrombolytic Treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Schulman et al.
Chest 2008;133:257S-298S.
ABSTRACT
| FULL TEXT
Acute Coronary Care in the Elderly, Part I: Non-ST-Segment-Elevation Acute Coronary Syndromes: A Scientific Statement for Healthcare Professionals From the American Heart Association Council on Clinical Cardiology: In Collaboration With the Society of Geriatric Cardiology
Alexander et al.
Circulation 2007;115:2549-2569.
ABSTRACT
| FULL TEXT
Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.
Sacco et al.
Circulation 2006;113:e409-e449.
ABSTRACT
| FULL TEXT
Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.
Sacco et al.
Stroke 2006;37:577-617.
ABSTRACT
| FULL TEXT
Low-Molecular-Weight Heparin for the Treatment of Venous Thromboembolism in the Elderly
Pineo and Hull
CLIN APPL THROMB HEMOST 2005;11:15-23.
ABSTRACT
Managing Complications of Anticoagulant Therapy
Smythe et al.
Journal of Pharmacy Practice 2004;17:327-346.
ABSTRACT
Hemorrhagic Complications of Anticoagulant Treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Levine et al.
Chest 2004;126:287S-310S.
ABSTRACT
| FULL TEXT
The Management of Venous Thromboembolic Disease in Older Adults
Rich
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2004;59:M34-41.
ABSTRACT
| FULL TEXT
Hemorrhagic Complications of Anticoagulant Treatment
Levine et al.
Chest 2001;119
:108S-121S.
FULL TEXT
Ruling Out Acute Deep Vein Thrombosis by ELISA Plasma D-Dimer Assay Versus Ultrasound in Inpatients More Than 70 Years Old
Le Blanche et al.
ANGIOLOGY 1999;50:873-882.
ABSTRACT
|
