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Perioperative venous thromboembolic disease and the emerging role of the novel oral anticoagulants: An analysis of the implications for perioperative management


1 Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona, USA
2 Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA
3 St. John Hospital and Medical Centers, Detroit, Michigan, USA
4 Mayo Pharmacy, Mayo Clinic, Scottsdale, Arizona, USA

Correspondence Address:
Martina Mookadam
Division of Family Medicine, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, Arizona 85259
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.166461

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Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 517-527

 

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Venous thromboembolism includes 2 inter-related conditions: Deep venous thrombosis and pulmonary embolism. Heparin and low-molecular-weight heparin followed by oral anticoagulation with vitamin K agonists is the first line and current accepted standard therapy with good efficacy. However, this therapeutic strategy has many limitations including the significant risk of bleeding and drug, food and disease interactions that require frequent monitoring. Dabigatran, rivaroxaban, apixaban, and edoxaban are the novel oral anticoagulants that are available for use in stroke prevention in atrial fibrillation and for the treatment and prevention of venous thromboembolism (HYPERLINK\l "1). Recent prospective randomized trials comparing the NOACs with warfarin have shown similar efficacy between the treatment strategies but fewer bleeding episodes with the NOACs. This paper presents an evidence-based review describing the efficacy and safety of the new anticoagulants compared to warfarin.






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1 Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona, USA
2 Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA
3 St. John Hospital and Medical Centers, Detroit, Michigan, USA
4 Mayo Pharmacy, Mayo Clinic, Scottsdale, Arizona, USA

Correspondence Address:
Martina Mookadam
Division of Family Medicine, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, Arizona 85259
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.166461

Rights and Permissions

Venous thromboembolism includes 2 inter-related conditions: Deep venous thrombosis and pulmonary embolism. Heparin and low-molecular-weight heparin followed by oral anticoagulation with vitamin K agonists is the first line and current accepted standard therapy with good efficacy. However, this therapeutic strategy has many limitations including the significant risk of bleeding and drug, food and disease interactions that require frequent monitoring. Dabigatran, rivaroxaban, apixaban, and edoxaban are the novel oral anticoagulants that are available for use in stroke prevention in atrial fibrillation and for the treatment and prevention of venous thromboembolism (HYPERLINK\l "1). Recent prospective randomized trials comparing the NOACs with warfarin have shown similar efficacy between the treatment strategies but fewer bleeding episodes with the NOACs. This paper presents an evidence-based review describing the efficacy and safety of the new anticoagulants compared to warfarin.






[FULL TEXT] [PDF]*


        
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