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Dual anti-platelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary intervention or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction, unstable angina). DAPT duration has been frequently discussed. Currently, guideline recommendations strengthen the importance of individualized treatment to reduce bleeding risk based on clinical predictors, of which older age is an important one. Patients aged \u226575\u2009years are often underrepresented in randomized clinical trials, but present a patient cohort deemed both at heightened ischaemic as well as bleeding risk. We aimed to summarize the evidence or the lack of evidence for anti-platelet treatment strategies in patients aged \u226575\u2009years including combinations with anticoagulants in secondary prevention or coronary interventions in elderly patients with atrial fibrillation. This review article represents the author\u2019s interpretation of available data and is not discussed by a formal task force; it is intended to point out missing evidence and to provide age-specific data for individualized decision making, which is currently encouraged by the guidelines.<\/jats:p>","DOI":"10.1093\/ehjcvp\/pvz032","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T15:10:30Z","timestamp":1564758630000},"page":"57-68","source":"Crossref","is-referenced-by-count":18,"title":["Anti-thrombotic strategies in elderly patients receiving platelet inhibitors"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3206-6162","authenticated-orcid":false,"given":"Andreas","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, D Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Flierl","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, D Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, D Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,8,6]]},"reference":[{"key":"2020010703580748500_pvz032-B1","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1056\/NEJM199604253341702","article-title":"A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents","volume":"334","author":"Schomig","year":"1996","journal-title":"N Engl J Med"},{"key":"2020010703580748500_pvz032-B2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/eurheartj\/ehx419","article-title":"2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS","volume":"39","author":"Valgimigli","year":"2018","journal-title":"Eur Heart J"},{"key":"2020010703580748500_pvz032-B3","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1161\/CIRCULATIONAHA.110.009449","article-title":"Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium","volume":"123","author":"Mehran","year":"2011","journal-title":"Circulation"},{"key":"2020010703580748500_pvz032-B4","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1056\/NEJM199309023291001","article-title":"An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction","volume":"329","year":"1993","journal-title":"N Engl J Med"},{"key":"2020010703580748500_pvz032-B5","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2005.01204.x","article-title":"Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients","volume":"3","author":"Schulman","year":"2005","journal-title":"J Thromb Haemost"},{"key":"2020010703580748500_pvz032-B6","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1111\/jth.13140","article-title":"Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH","volume":"13","author":"Kaatz","year":"2015","journal-title":"J Thromb Haemost"},{"key":"2020010703580748500_pvz032-B7","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1056\/NEJMoa0904327","article-title":"Ticagrelor versus clopidogrel in patients with acute coronary syndromes","volume":"361","author":"Wallentin","year":"2009","journal-title":"N Engl J Med"},{"key":"2020010703580748500_pvz032-B8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1161\/01.CIR.76.1.142","article-title":"Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase. 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