老年人急性和围手术期及长期抗血栓治疗策略解读

Interpretation of Acute,Perioperative,and Long-term Antithrombotic Therapy Strategies in the Elderly

2023年1月,欧洲心脏病学会(ESC)血栓工作组发布了其在2022年更新的老年人急性、围手术期和长期抗血栓治疗共识文件。由于老年人常伴有多器官变化及多种疾病,出血性和血栓性事件风险增加,常服用多种药物,对治疗的依从性差,因此为临床抗栓管理带来很大的挑战。该文对如何评估血栓及出血风险,口服抗血栓药物的治疗策略,胃肠外抗血栓药物的治疗策略,围手术期抗血栓治疗方案进行解读,以期为临床医生治疗老年抗血栓提供参考。

In January 2023,the European Society of Cardiology(ESC)Working Group on thrombosis published its 2022 updated consensus document on acute,perioperative,and long-term antithrombotic therapy for the elderly.Since the elderly are often accompanied with multiple organ changes and multiple diseases,the risk of hemorrhagic and ischemic events is increased,and they often take multiple drugs and have poor compliance with treatment,which pose significant challenges to clinical antithrombotic management.This article elaborates on how to assess the risk of thrombosis and bleeding,the treatment strategy of oral antithrombotic drugs,the treatment strategy of parenteral antithrombotic drugs,and the perioperative antithrombotic therapy protocols,with the aim of providing clinicians with references for the treatment of antithrombosis in the elderly.