Oral anticoagulant therapy - Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines

W Ageno, Alexander Gallus, A Wittowsky, Mark Crowther, Elaine Hylek, Gualtiero Palareti

    Research output: Contribution to journalArticlepeer-review

    1061 Citations (Scopus)

    Abstract

    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 specifi c 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.

    Original languageEnglish
    Pages (from-to)e44S-e88S
    Number of pages45
    JournalChest
    Volume141
    Issue number2 SUPPL.
    DOIs
    Publication statusPublished - Feb 2012

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