Prevention of venous thrombosis (phlebothromboprophylaxis) in clinical practice


Authors: P. Gavornik
Authors‘ workplace: II. interná klinika LFUK – FNsP, Bratislava, Slovenská republika ;  Prednosta: prof. MUDr. Andrej Dukát, CSc., FESC. ;  Prvé angiologické pracovisko (PAP) ;  Vedúci lekár: doc. MUDr. Peter Gavorník, PhD., mim. prof.
Published in: Prakt. Lék. 2009; 89(8): 454-457
Category: Therapy

Overview

Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely used in the prevention and treatment of venous thromboembolism (VTE). Unfractionated heparin, low molecular weight heparin, and fondaparinux have been shown to be effective and safe in reducing VTE risk. Despite high efficacy, these medicaments have limitations, which have become more apparent with the current widening of the indications for either primary thromboprophylaxis (PTP) or indefinite and even lifelong secondary thromboprophylaxis (STP). There is a need for new effective and safe medicaments with specific antithrombotic action, oral administration and convenient dosing without monitoring. During the last decade new antithrombotics have been developed either blocking selectively one coagulation enzyme or inhibiting a particular step in the coagulation cascade.

Key words:
veins, venous thromboembolism, phlebothromboprophylaxis, heparin, warfarin, new venous antithrombotics.


Sources

1. Ansell, J. Factor Xa or thrombin: is factor Xa a better target? J. Thromb. Haemost. 2007, 5(Suppl 1), p. 60-64.

2. Antithrombotic and thrombolytic therapy: American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines (8th edition). Chest 2008, 133, (6 Suppl), 67S-968S.

3. Bátorová, A. Pokroky v antitrombotickej liečbe – antitrombotiká s anti-Xa účinkom. Vnitř Lék. 2009, 55(3), s. 295-301.

4. Cohen, A.T. et al. for ARTEMIS Investigators. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomized placebo controlled trial. BMJ 2006, 332, s. 325-329.

5. Cohen, A.T., Alikhan, R., Arcelus, J. et al. Assessment of venous thromboembolism risk and the benefits of thromboprophylaxis in medical patients. Thromb. Haemost. 2005, 94, p. 750-759.

6. Gašpar, Ľ., Fulleová, M., Ambrózy, E. a kol. Účinok rôznych druhov antidekubitálnych podložiek na mikrocirkuláciu kože. Paliat. med. lieč. boles. 2008, 1(3), s. 139-142.

7. Gavorník, P. Prevencia artériovej trombózy (artériotromboprofylaxia) v klinickej praxi. Prakt lék. 2009; 89, 7, s. 393-395.

8. Gavorník, P. Cestovná trombóza a varixy. Interní Med. 2008, 10(5), s. 219-223.

9. Gavorník, P. Kompresívna terapia v prevencii a liečbe chorôb vénového a lymfového cievneho systému dolných končatín. Gen. angiol. 2002, 2(2), s. 83-87.

10. Gavorník, P. Všeobecná angiológia. Angiologická propedeutika. Cievne choroby. 2. vyd. Bratislava: Univerzita Komenského – Vydavateľstvo UK, 2001. 268 s. ISBN 80-223-1608-3.

11. Hirsh, J. Fondaparinux. Hamilton: BC Decker Inc, 2007, 58 p.

12. Kriška, M. Rivaroxaban (Xarelto). Interná med. 2009, 9(Suppl 1), 12S-14S.

13. Kubisz, P., Staško, J., Kotuličová, D. Nové možnosti prevencie a liečby venózneho tromboembolizmu pri artroplastike kolena a bedra v ortopedickej chirurgii. Ambulantná terapia 2008, 6(4), s. 233-240.

14. Le Gal, G., Righini, M., Roy, PM. et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann. Intern. Med. 2006, 144 (3), p. 165-171.

15. Nicolaides, A.N., Fareed, J., Kakkar, A.K. et al. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int. Angiol. 2006, 25(2), p. 101-161.

16. Remková, A. Prevencia venóznej trombózy a pľúcnej embólie v internej medicíne. Interná med. 2008, 8(1), s. 13-17.

17. The seventh American College of Chest Physicians (ACCP) conference on antithrombotic and thrombolytic therapy. From evidence to application. Chest 2004, 126 (3 Suppl), 1S-696S.

18. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2008, 29(18), p. 2276-2315.

19. Turpie, A.G. Extended duration of thromboprophylaxis in acutely ill medical patients: optimizing therapy? J. Thromb. Haemost. 2007, 5(1), p. 5-11.

20. Weitz, J.I. Factor Xa or thrombin: is thrombin a better target? J. Thromb. Haemost. 2007, 5(Suppl 1), p. 65-67.

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