Anticoagulant: Difference between revisions
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'''Anticoagulants''' are "agents that prevent [[coagulation|blood clotting]]".<ref name="title">{{ | '''Anticoagulants''' are "agents that prevent [[coagulation|blood clotting]]".<ref name="title">{{MeSH|Anticoagulants}}</ref> They may be used to prevent [[embolism and thromboembolism]]. | ||
{{editintro}} | {{editintro}} | ||
==Vitamin K antagonists== | ==Vitamin K antagonists== | ||
===Warfarin=== | ===Warfarin=== | ||
{{main|warfarin}} | {{main|warfarin}} | ||
[[Warfarin]] is a commonly used oral anticoagulant that interferes with the Vitamin K dependent coagulation co-factors. | |||
Warfarin is a commonly used oral anticoagulant that interferes with the Vitamin K dependent coagulation co-factors. | |||
==Heparin== | ==Heparin== | ||
| Line 25: | Line 24: | ||
==Factor Xa inhibitors== | ==Factor Xa inhibitors== | ||
[[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> | ||
==Warfarin combined with heparin== | |||
[[Warfarin]] combined with [[hepari]]n did not benefit survivors of acute myocardial infarction in a [[randomized controlled trial]].<ref name="pmid11827919">{{cite journal |author=Fiore LD, Ezekowitz MD, Brophy MT, Lu D, Sacco J, Peduzzi P |title=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 |journal=Circulation |volume=105 |issue=5 |pages=557–63 |year=2002 |pmid=11827919 |doi= |issn=}}</ref> | |||
==References== | ==References== | ||
Revision as of 16:18, 24 January 2008
Anticoagulants are "agents that prevent blood clotting".[1] They may be used to prevent embolism and thromboembolism.
[]
Vitamin K antagonists
Warfarin
Warfarin is a commonly used oral anticoagulant that interferes with the Vitamin K dependent coagulation co-factors.
Heparin
Details of the usage of heparin are available in clinical practice guidelines by the American College of Chest Physicians[2]:
Direct thrombin inhibitors
Direct thrombin inhibitors bind directly to thrombin.[3]
- 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
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.[4]
Warfarin combined with heparin
Warfarin combined with heparin did not benefit survivors of acute myocardial infarction in a randomized controlled trial.[5]
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.
- ↑ 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.
- ↑ 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]
See also
External links
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines