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Thromb Haemost 2013; 109(05): 769-786
DOI: 10.1160/TH12-06-0403
Position Paper
Schattauer GmbH

Parenteral anticoagulants in heart disease: Current status and perspectives (Section II)

Position Paper of the ESC Working Group on Thrombosis – Task Force on Anticoagulants in Heart Disease
Raffaele De Caterina   *
1   Cardiovascular Division, Ospedale SS. Annunziata, G. d’Annunzio University, Chieti, Italy
,
Steen Husted   *
2   Medical-Cardiological Department, Aarhus Sygehus, Aarhus, Denmark
,
Lars Wallentin   *
3   Cardiology, Uppsala Clinical Research Centre and Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Felicita Andreotti   **
4   Department of Cardiology, Catholic University, Rome, Italy
,
Harald Arnesen   **
5   Medical Department, Oslo University Hospital, Ulleval, Norway
,
Fedor Bachmann   **
6   Department of Medicine, University of Lausanne, Lausanne, Switzerland
,
Colin Baigent   **
7   Cardiovascular Science, Oxford University, Oxford, UK
,
Kurt Huber   **
8   3rd Department of Medicine, Wilhelminenspital, Vienna, Austria
,
Jørgen Jespersen   **
9   Unit for Thrombosis Research, University of Southern Denmark, Esbjerg, Denmark
,
Steen Dalby Kristensen   **
10   Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
,
Gregory Y. H. Lip   **
11   Haemostasis Thrombosis & Vascular Biology Unit, Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
,
João Morais   **
12   Cardiology, Leiria Hospital, Leiria, Portugal
,
Lars Hvilsted Rasmussen   **
13   Department of Cardiology, Thrombosis Center Aalborg, Aarhus University Hospital, Aalborg, Denmark
,
Agneta Siegbahn   **
14   Coagulation and Inflammation Science, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Freek W. A. Verheugt   **
15   Cardiology, Medical Centre, Radboud University Nijmegen, Nijmegen, Netherlands
,
Jeffrey I. Weitz   **
16   Thrombosis & Atherosclerosis Research Institute, Hamilton General Hospital, Hamilton, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Received: 14 June 2012

Accepted after minor revision: 25 March 2012

Publication Date:
22 November 2017 (online)

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Summary

Anticoagulants are a mainstay of cardiovascular therapy, and parenteral anticoagulants have widespread use in cardiology, especially in acute situations. Parenteral anticoagulants include unfractionated heparin, low-molecular-weight heparins, the synthetic pentasaccharides fondaparinux, idraparinux and idrabiotaparinux, and parenteral direct thrombin inhibitors. The several shortcomings of unfractionated heparin and of low-molecular-weight heparins have prompted the development of the other newer agents. Here we review the mechanisms of action, pharmacological properties and side effects of parenteral anticoagulants used in the management of coronary heart disease treated with or without percutaneous coronary interventions, cardioversion for atrial fibrillation, and prosthetic heart valves and valve repair. Using an evidence-based approach, we describe the results of completed clinical trials, highlight ongoing research with currently available agents, and recommend therapeutic options for specific heart diseases.

Keywords

Parenteral anticoagulants - coagulation - heart disease - coronary heart disease - heart failure - atrial fibrillation

* Coordinating Committee Member


** Task Force Member


 

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