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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Friday, December 11, 2015

Nuevos anticoagulantes en TEP

Resultado de imagen de cochrane
Cochrane - Published: 4 December 2015 - Authors: Robertson L, Kesteven P, McCaslin JE
Venous thromboembolism is a condition where a blood clot forms in the deep veins (DVT) (most commonly of the leg) and can travel up to block the arteries in the lungs (pulmonary embolism). Pulmonary embolism is life-threatening and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a pulmonaryembolism can increase with risk factors, including previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), blood disorders (thrombophilia) and trauma. A pulmonary embolism is diagnosed by determining the risk factors and scanning the lungs to check for a clot. If apulmonary embolism is confirmed, patients are treated with an anticoagulant. This prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Recently two classes of direct oral anticoagulants (DOACs) have been developed: direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re-dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs compared with conventional treatment.
Authors' conclusions: 
Moderate to high quality evidence suggests that there are no differences between DOACs and standard anticoagulation for the long-term treatment ofpulmonary embolism, for the outcomes recurrent pulmonary embolism, recurrent venous thromboembolism, DVT, all-cause mortality and major bleeding."

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