Anticoagulant: Difference between revisions
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* [[Fondaparinux]] | * [[Fondaparinux]] | ||
* [[Idraparinux]] is a synthetic derivative of heparin that has a long half life that allows once-weekly dosage. A [[randomized controlled trial]] compared idraparinux to warfarin and found that [[idraparinux]] is equivalent for [[deep venous thrombosis]] but is inferior for [[pulmonary embolism]].<ref name="pmid17855670">{{cite journal |author=Buller HR, Cohen AT, Davidson B, ''et al'' |title=Idraparinux versus standard therapy for venous thromboembolic disease |journal=N. Engl. J. Med. |volume=357 |issue=11 |pages=1094–104 |year=2007 |pmid=17855670 |doi=10.1056/NEJMoa064247}}</ref> | * [[Idraparinux]] is a synthetic derivative of heparin that has a long half life that allows once-weekly dosage. A [[randomized controlled trial]] compared idraparinux to warfarin and found that [[idraparinux]] is equivalent for [[deep venous thrombosis]] but is inferior for [[pulmonary embolism]].<ref name="pmid17855670">{{cite journal |author=Buller HR, Cohen AT, Davidson B, ''et al'' |title=Idraparinux versus standard therapy for venous thromboembolic disease |journal=N. Engl. J. Med. |volume=357 |issue=11 |pages=1094–104 |year=2007 |pmid=17855670 |doi=10.1056/NEJMoa064247}}</ref> | ||
* [[Rivaroxaban]] can prevent [[embolism and thrombosis]] during [[perioperative care]] according to [[randomized controlled trials]].<ref>Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial | * [[Rivaroxaban]] can prevent [[embolism and thrombosis]] during [[perioperative care]] according to [[randomized controlled trials]] of two weeks of therapy after kne arthoplasty<ref name="pmid18579812">{{cite journal |author=Lassen MR, Ageno W, Borris LC, ''et al'' |title=Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty |journal=The New England journal of medicine |volume=358 |issue=26 |pages=2776–86 |year=2008 |month=June |pmid=18579812 |doi=10.1056/NEJMoa076016 |url=http://content.nejm.org/cgi/content/full/358/26/2776 |issn=}}</ref> or 5 weeks of therapy after hip arthroplasty<ref name="pmid18579811">{{cite journal |author=Eriksson BI, Borris LC, Friedman RJ, ''et al'' |title=Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty |journal=The New England journal of medicine |volume=358 |issue=26 |pages=2765–75 |year=2008 |month=June |pmid=18579811 |doi=10.1056/NEJMoa0800374 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18579811&promo=ONFLNS19 |issn=}}</ref><ref name="pmid18582928">{{cite journal |author=Kakkar AK, Brenner B, Dahl OE, ''et al'' |title=Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial |journal=Lancet |volume=372 |issue=9632 |pages=31–9 |year=2008 |month=July |pmid=18582928 |doi=10.1016/S0140-6736(08)60880-6 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)60880-6 |issn=}}</ref> or fracture surgery<ref name="pmid11794148">{{cite journal |author=Eriksson BI, Bauer KA, Lassen MR, Turpie AG |title=Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery |journal=The New England journal of medicine |volume=345 |issue=18 |pages=1298–304 |year=2001 |month=November |pmid=11794148 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11794148&promo=ONFLNS19 |issn=}}</ref>. | ||
==Warfarin combined with heparin== | ==Warfarin combined with heparin== | ||
Revision as of 13:24, 6 November 2008
Anticoagulants are "agents that prevent blood clotting".[1] They may be used to prevent embolism and thrombosis.
[]
Vitamin K antagonists
Warfarin
Warfarin is a commonly used oral anticoagulant that interferes with the Vitamin K dependent coagulation co-factors.
Heparins
Unfractionated heparin
Details of the usage of heparin are available in clinical practice guidelines by the American College of Chest Physicians[2]:
Low molecular weight heparin
The last dose of low molecular weight heparin prior to procedures should occur 24 hours before the procedure in order to prevent high residual anti-Xa levels.[3]
Direct thrombin inhibitors
Direct thrombin inhibitors bind directly to thrombin.[4]
- Argatroban is for treating heparin-induced thrombocytopenia (HIT)
- Bivalirudin is a recombinant protein
- Dabigatran
- Desirudin
- Hirudin is a recombinant protein for treating heparin-induced thrombocytopenia (HIT)
- Lepirudin
- Ximelagatran is a recombinant protein that is an oral direct thrombin inhibitor
Factor Xa inhibitors
- Fondaparinux
- Idraparinux is a synthetic derivative of heparin that has a long half life that allows once-weekly dosage. A randomized controlled trial compared idraparinux to warfarin and found that idraparinux is equivalent for deep venous thrombosis but is inferior for pulmonary embolism.[5]
- Rivaroxaban can prevent embolism and thrombosis during perioperative care according to randomized controlled trials of two weeks of therapy after kne arthoplasty[6] or 5 weeks of therapy after hip arthroplasty[7][8] or fracture surgery[9].
Warfarin combined with heparin
Warfarin combined with heparin did not benefit survivors of acute myocardial infarction in a randomized controlled trial.[10]
Warfarin combined with heparin reduced events, but increased bleeding, among survivors of acute myocardial infarction in a randomized controlled trial.[11]
References
- ↑ Anonymous (2024), Anticoagulants (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Hirsh J, Raschke R (2004). "Heparin and low-molecular-weight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest 126 (3 Suppl): 188S-203S. DOI:10.1378/chest.126.3_suppl.188S. PMID 15383472. Research Blogging.
- ↑ Whitlock RP, Crowther MA, Warkentin TE, Blackall MH, Farrokhyar F, Teoh KH (2007). "Warfarin cessation before cardiopulmonary bypass: lessons learned from a randomized controlled trial of oral vitamin K". Ann. Thorac. Surg. 84 (1): 103–8. DOI:10.1016/j.athoracsur.2007.03.014. PMID 17588394. Research Blogging.
- ↑ Di Nisio M, Middeldorp S, Büller HR (2005). "Direct thrombin inhibitors". N. Engl. J. Med. 353 (10): 1028–40. DOI:10.1056/NEJMra044440. PMID 16148288. Research Blogging.
- ↑ Buller HR, Cohen AT, Davidson B, et al (2007). "Idraparinux versus standard therapy for venous thromboembolic disease". N. Engl. J. Med. 357 (11): 1094–104. DOI:10.1056/NEJMoa064247. PMID 17855670. Research Blogging.
- ↑ Lassen MR, Ageno W, Borris LC, et al (June 2008). "Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty". The New England journal of medicine 358 (26): 2776–86. DOI:10.1056/NEJMoa076016. PMID 18579812. Research Blogging.
- ↑ Eriksson BI, Borris LC, Friedman RJ, et al (June 2008). "Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty". The New England journal of medicine 358 (26): 2765–75. DOI:10.1056/NEJMoa0800374. PMID 18579811. Research Blogging.
- ↑ Kakkar AK, Brenner B, Dahl OE, et al (July 2008). "Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial". Lancet 372 (9632): 31–9. DOI:10.1016/S0140-6736(08)60880-6. PMID 18582928. Research Blogging.
- ↑ Eriksson BI, Bauer KA, Lassen MR, Turpie AG (November 2001). "Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery". The New England journal of medicine 345 (18): 1298–304. PMID 11794148. [e]
- ↑ Fiore LD, Ezekowitz MD, Brophy MT, Lu D, Sacco J, Peduzzi P (2002). "Department of Veterans Affairs Cooperative Studies Program Clinical Trial comparing combined warfarin and aspirin with aspirin alone in survivors of acute myocardial infarction: primary results of the CHAMP study". Circulation 105 (5): 557–63. PMID 11827919. [e]
- ↑ Hurlen M, Abdelnoor M, Smith P, Erikssen J, Arnesen H (2002). "Warfarin, aspirin, or both after myocardial infarction". N. Engl. J. Med. 347 (13): 969–74. DOI:10.1056/NEJMoa020496. PMID 12324552. Research Blogging.