Oral Anticoagulant Therapy Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Oral Anticoagulant Therapy Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
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DOI：
10.1378/chest.11-2292
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发表时间：
2012-02-01
期刊：
影响因子：
9.6
通讯作者：
Palareti, Gualtiero
中科院分区：
文献类型：
--
作者：
Ageno, Walter;Gallus, Alexander S.;Palareti, Gualtiero
背景资料：本文的目的是总结已发表的文献有关的药代动力学和药效学的口服抗凝药物，目前可用于临床使用和其他方面的管理。方法：我们进行了一个标准的审查已发表的文章，重点是实验室和临床特点的维生素K拮抗剂，直接凝血酶抑制剂，达比加群酯;结果：对每种口服抗凝药物的抗血栓作用、相互作用和抗凝强度的监测进行了详细描述和讨论，但未提供具体建议。此外，我们描述和讨论的临床应用和最佳剂量的口服抗凝治疗，实际问题有关的启动和监测，不良事件，如出血和其他潜在的副作用，以及可用的策略reversion.Conclusions：有大量的证据，维生素K拮抗剂的实验室和临床特征。越来越多的证据表明，达比加群和利伐沙班是首批可用于临床的新型口服抗凝药物。
Background: The objective of this article is to summarize the published literature concerning the pharmacokinetics and pharmacodynamics of oral anticoagulant drugs that are currently available for clinical use and other aspects related to their management.Methods: We carried out a standard review of published articles focusing on the laboratory and clinical characteristics of the vitamin K antagonists; the direct thrombin inhibitor, dabigatran etexilate; and the direct factor Xa inhibitor, rivaroxaban.Results: The antithrombotic effect of each oral anticoagulant drug, the interactions, and the monitoring of anticoagulation intensity are described in detail and discussed without providing specific recommendations. Moreover, we describe and discuss the clinical applications and optimal dosages of oral anticoagulant therapies, practical issues related to their initiation and monitoring, adverse events such as bleeding and other potential side effects, and available strategies for reversal.Conclusions: There is a large amount of evidence on laboratory and clinical characteristics of vitamin K antagonists. A growing body of evidence is becoming available on the first new oral anticoagulant drugs available for clinical use, dabigatran and rivaroxaban.