Drugs & Aging

, Volume 25, Issue 12, pp 1049–1060 | Cite as

Current Issues in Thromboprophylaxis in the Elderly

  • Parminder S. Chaggar
  • Kevin S. Channer
Review Article


The elderly are at particularly high risk for arterial and venous thromboembolism, both of which are associated with significant morbidity and mortality in this age group. However, this age group often receives inadequate thromboprophylaxis because of concerns about bleeding risk, which is often over-estimated, denying patients the benefit of proven antithrombotic regimens. Guidelines advocate active and comprehensive thromboprophylactic strategies across all age groups and recent studies have addressed age considerations in both arterial and venous embolic disorders. Pharmacological thromboprophylaxis has repeatedly been shown to have a favourable risk-benefit profile, including in elderly populations. The benefits of thromboprophylaxis have long been recognized in surgical patients and recent studies have confirmed the safety and efficacy of thromboprophylaxis in medical patients, with most trials having included elderly cohorts. Given the difficulties and inconvenience associated with use of current anticoagulants, new drugs are under development and whilst some have been associated with significant adverse effects, others have demonstrated low bleeding risks without the need for coagulation monitoring. Meanwhile, other new agents currently on the market, such as fondaparinux sodium, have gained license for use in orthopaedic and general surgery patients, although clinical experience with these agents in elderly populations is limited. This article discusses the latest developments and current opinions regarding thromboprophylaxis, with particular emphasis on its relevance to the elderly population.


Atrial Fibrillation Warfarin Rivaroxaban Enoxaparin Sodium Dabigatran Etexilate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


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Authors and Affiliations

  1. 1.Cardiothoracic Transplant CentreWythenshawe HospitalManchesterUK
  2. 2.Department of CardiologyRoyal Hallamshire HospitalSheffieldUK

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