Parenteral anticoagulants in heart disease: Current status and perspectives (Section II) Position Paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease

被引:30
作者
De Caterina, Raffaele [1 ]
Husted, Steen [2 ]
Wallentin, Lars [3 ,4 ]
Andreotti, Felicita [5 ]
Arnesen, Harald [6 ]
Bachmann, Fedor [7 ]
Baigent, Colin [8 ]
Huber, Kurt [9 ]
Jespersen, Jorgen [10 ]
Kristensen, Steen Dalby [11 ]
Lip, Gregory Y. H. [12 ]
Morais, Joao [13 ]
Rasmussen, Lars Hvilsted [14 ]
Siegbahn, Agneta [4 ]
Verheugt, Freek W. A. [15 ]
Weitz, Jeffrey I. [16 ]
机构
[1] Univ G dAnnunzio, Osped SS Annunziata, Div Cardiovasc, Chieti, Italy
[2] Aarhus Sygehus, Dept Med Cardiol, Aarhus, Denmark
[3] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden
[4] Uppsala Univ, Dept Med Sci, Uppsala, Sweden
[5] Catholic Univ, Dept Cardiol, Rome, Italy
[6] Oslo Univ Hosp, Dept Med, Ulleval, Norway
[7] Univ Lausanne, Dept Med, Lausanne, Switzerland
[8] Univ Oxford, Oxford, England
[9] Wilhelminenspital Stadt Wien, Dept Med 3, Vienna, Austria
[10] Univ Southern Denmark, Unit Thrombosis Res, Esbjerg, Denmark
[11] Aarhus Univ Hosp, Dept Cardiol, DK-8000 Aarhus, Denmark
[12] City Hosp, Ctr Cardiovasc Sci, Haemostasis Thrombosis & Vasc Biol Unit, Birmingham, W Midlands, England
[13] Leiria Hosp, Leiria, Portugal
[14] Aarhus Univ Hosp, Thrombosis Ctr Aalborg, Dept Cardiol, Aalborg, Denmark
[15] Radboud Univ Nijmegen, Med Ctr, NL-6525 ED Nijmegen, Netherlands
[16] Hamilton Gen Hosp, Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada
关键词
Parenteral anticoagulants; coagulation; heart disease; coronary heart disease; heart failure; atrial fibrillation; MOLECULAR-WEIGHT HEPARIN; ACUTE CORONARY SYNDROMES; ACUTE MYOCARDIAL-INFARCTION; GLYCOPROTEIN IIB/IIIA INHIBITOR; VS. UNFRACTIONATED HEPARIN; EARLY INVASIVE STRATEGY; FACTOR-XA INHIBITOR; HIGH-RISK PATIENTS; ST-ELEVATION; INDUCED THROMBOCYTOPENIA;
D O I
10.1160/TH12-06-0403
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Anticoagulants are a mainstay of cardiovascular therapy, and parenteral anticoagulants have widespread use in cardiology, especially in acute situations. Parenteral anticoagulants include unfractionated heparin, low-molecular-weight heparins, the synthetic pentasaccharides fondaparinux, idraparinux and idrabiotaparinux, and parenteral direct thrombin inhibitors. The several shortcomings of unfractionated heparin and of low-molecular-weight heparins have prompted the development of the other newer agents. Here we review the mechanisms of action, pharmacological properties and side effects of parenteral anticoagulants used in the management of coronary heart disease treated with or without percutaneous coronary interventions, cardioversion for atrial fibrillation, and prosthetic heart valves and valve repair. Using an evidence-based approach, we describe the results of completed clinical trials, highlight ongoing research with currently available agents, and recommend therapeutic options for specific heart diseases.
引用
收藏
页码:769 / 786
页数:18
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