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Abrignani MG, Lucà F, Abrignani V, Pelaggi G, Aiello A, Colivicchi F, Fattirolli F, Gulizia MM, Nardi F, Pino PG, Parrini I, Rao CM. A Look at Primary and Secondary Prevention in the Elderly: The Two Sides of the Same Coin. J Clin Med 2024; 13:4350. [PMID: 39124617 PMCID: PMC11312802 DOI: 10.3390/jcm13154350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
The global population is experiencing an aging trend; however, this increased longevity is not necessarily accompanied by improved health in older age. A significant consequence of this demographic shift is the rising prevalence of multiple chronic illnesses, posing challenges to healthcare systems worldwide. Aging is a major risk factor for multimorbidity, which marks a progressive decline in resilience and a dysregulation of multisystem homeostasis. Cardiovascular risk factors, along with aging and comorbidities, play a critical role in the development of heart disease. Among comorbidities, age itself stands out as one of the most significant risk factors for cardiovascular disease, with its prevalence and incidence notably increasing in the elderly population. However, elderly individuals, especially those who are frail and have multiple comorbidities, are under-represented in primary and secondary prevention trials aimed at addressing traditional cardiovascular risk factors, such as hypercholesterolemia, diabetes mellitus, and hypertension. There are concerns regarding the optimal intensity of treatment, taking into account tolerability and the risk of drug interactions. Additionally, uncertainty persists regarding therapeutic targets across different age groups. This article provides an overview of the relationship between aging and cardiovascular disease, highlighting various cardiovascular prevention issues in the elderly population.
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Affiliation(s)
| | - Fabiana Lucà
- O.U. Interventional Cardiology, Bianchi Melacrino Morelli Hospital, 89124 Reggio Calabria, Italy; (F.L.)
| | - Vincenzo Abrignani
- Internal Medicine and Stroke Care Ward, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90141 Palermo, Italy
| | - Giuseppe Pelaggi
- O.U. Interventional Cardiology, Bianchi Melacrino Morelli Hospital, 89124 Reggio Calabria, Italy; (F.L.)
| | | | - Furio Colivicchi
- Cardiology Division, San Filippo Neri Hospital, 00135 Rome, Italy
| | - Francesco Fattirolli
- Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, 50121 Firenze, Italy
| | | | - Federico Nardi
- O.U. Cardiology, Santo Spirito Hospital, 15033 Casale Monferrato, Italy;
| | | | - Iris Parrini
- Cardiology Department, Mauriziano Umberto I Hospital, 10128 Turin, Italy
| | - Carmelo Massimiliano Rao
- O.U. Interventional Cardiology, Bianchi Melacrino Morelli Hospital, 89124 Reggio Calabria, Italy; (F.L.)
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Matarese M, Cervino G, Fiorillo L, Stelitano C, Imbesi Bellantoni M, Meto A, Greco Lucchina A, Tornello FA, Runci Anastasi M, Rengo C. A cohort study on anticoagulant therapy risks in dental patients after multiple extractions. Minerva Dent Oral Sci 2021; 70:196-205. [PMID: 34842406 DOI: 10.23736/s2724-6329.21.04551-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Due to technology and pharmaceutical science and increasing life expectancy, the patient population is continuously aging. Patients requiring dental extractions often have systemic and/or chronic diseases and are undergoing polypharmacologic therapy. Oral surgeons often interface with patients who perform anticoagulant therapy. The main aim of this study was to clarify what the contraindications and short-/long-term complications may be. METHODS A sample of 298 patients (mean age 58 years) who required multiple surgical dental extractions has been taken in consideration. Patients were divided into groups and subgroups according to the anticoagulant drug therapy. RESULTS Long-term complications represented variable bleeding between groups from 8 hours to 7 days after surgery. The One-Way ANOVA Test was used to compare the results between groups. Patients treated with direct oral anticoagulants showed fewer intraoperative problems, but further studies and further collaboration between doctors, cardiologists and oral dentists/surgeons are certainly needed to manage these patients in a predictable manner. CONCLUSIONS This study showed that using direct oral anticoagulants drugs results in few intraoperative bleeding, less postoperative hemorrhagic complications, and an easier administration of the drugs respect vitamin K antagonists, with mild and manageable complications.
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Affiliation(s)
- Marco Matarese
- School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy
- IRCCS Centro Neurolesi "Bonino-Pulejo, " Messina, Italy
| | - Gabriele Cervino
- School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy
| | - Luca Fiorillo
- School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy -
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Carmelo Stelitano
- School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy
| | - Martina Imbesi Bellantoni
- School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, Tirana, Albania
| | | | | | - Michele Runci Anastasi
- IRCCS Centro Neurolesi "Bonino-Pulejo, " Messina, Italy
- Department of Maxillo-Facial Surgery, Sapienza University, Rome, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy
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