[Extended options of anticoagulant treatment in thromboembolism].

Abstract

Thromboembolic disease (TD) is a relatively common disease with acute risk of death and potential long-term consequences in term of postthrombotic syndrome or chronic pulmonary hypertension. Anticoagulant therapy is the basic therapeutic procedure; thrombolytic therapy and the introduction cava filter are appropriately indicated for individual cases. In past few years, new direct oral anticoagulant drugs (NOAC) have occurred - Xa factor or thrombin inhibitors which have demonstrated the same efficacy and even higher safety in comparison to conventional treatment. In mid 2014, 3 drugs of this group are registered in Czech Republic - rivaroxaban (Xarelto®), dabigatran (Pradaxa®) and apixaban (Eliquis®). These drugs have comparable efficacy and safety but they differ in schedule of dose administration. Rivaroxaban and apixaban can be administered immediately after diagnosis of venous thrombosis or hemodynamically stable pulmonary embolism. LMWH application has to precede few days the administration of dabigatran. Limitation of new drugs is their price. Unavailability of antidotes is temporary because current researches continue to find one for dabigatran and another for both of xabans. Duration of anticoagulant treatment after acute phase depends on the presence of thrombosis risk factors and the individual bleeding risk. Minimal duration of anticoagulant therapy is 3 months, commonly 6-12 months and in high risk patients it is "long term" treatment. Good results of new anticoagulant drugs in trials in term of thromboembolism recurrence prevention may change established habits in TD patients with long term treatment.

• Authors: Debora Karetová, Jan Bultas
• Journal: Vnitrni lekarstvi (Vnitr Lek) Vol. 60 Issue 11 Pg. 977-84 (Nov 2014) ISSN: 0042-773X [Print] Czech Republic
• Vernacular Title: Rozšiřující se možnosti antikoagulační léčby tromboembolické nemoci.
• PMID: 25600045 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antithrombins
• Benzimidazoles
• Morpholines
• Pyrazoles
• Pyridones
• Thiophenes
• beta-Alanine
• apixaban
• Rivaroxaban
• Dabigatran

Topics

• Administration, Oral
• Aged
• Antithrombins (adverse effects, therapeutic use)
• Benzimidazoles (adverse effects, therapeutic use)
• Czech Republic
• Dabigatran
• Hemorrhage (chemically induced, prevention & control)
• Humans
• Male
• Middle Aged
• Morpholines (adverse effects, therapeutic use)
• Pulmonary Embolism (drug therapy)
• Pyrazoles (adverse effects, therapeutic use)
• Pyridones (adverse effects, therapeutic use)
• Rivaroxaban
• Thiophenes (adverse effects, therapeutic use)
• Thromboembolism (drug therapy, prevention & control)
• Venous Thrombosis (drug therapy, prevention & control)
• beta-Alanine (adverse effects, analogs & derivatives, therapeutic use)