Thromb Haemost 2013; 110(04): 681-688
DOI: 10.1160/TH12-12-0928
Theme Issue Article
Schattauer GmbH

Antithrombotic therapy in obesity

Lina Badimon
1   Centro de Investigación Cardiovascular, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau and IIB-Santpau, Barcelona, Spain
2   CIBEROBN Instituto de Salud Carlos III, Barcelona, Spain
3   Cátedra de Investigación Cardiovascular, (UAB-HSCSP-Fundación Jesús Serra), Barcelona, Spain
,
Rodrigo Hernández Vera
1   Centro de Investigación Cardiovascular, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau and IIB-Santpau, Barcelona, Spain
2   CIBEROBN Instituto de Salud Carlos III, Barcelona, Spain
,
Teresa Padró
1   Centro de Investigación Cardiovascular, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau and IIB-Santpau, Barcelona, Spain
2   CIBEROBN Instituto de Salud Carlos III, Barcelona, Spain
,
Gemma Vilahur
1   Centro de Investigación Cardiovascular, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau and IIB-Santpau, Barcelona, Spain
2   CIBEROBN Instituto de Salud Carlos III, Barcelona, Spain
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Publikationsverlauf

Received: 17. Dezember 2012

Accepted after minor revision: 11. März 2013

Publikationsdatum:
01. Dezember 2017 (online)

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summary

Clinical management of obese subjects to reduce their risk of suffering cardiovascular events is complex. Obese patients typically require preventive strategies, life-style modifications, and multi-drug therapy to address obesity-induced co-morbidities. Data regarding the effects of excess weight on the pharmacokinetics of most drugs is scarce as these individuals are often excluded from clinical trials. However, the physiological alterations observed in obese patients and their lower response to some antiplatelet agents and anticoagulants have suggested that dosage regimes need to be adjusted for these subjects. In this review we will briefly discuss platelet alterations that can contributeto increased thrombotic risk, analyse existing data regarding the effects of obesity on drug pharmacokinetics focusing on antiplatelet agents and anticoagulants, and we will describe the beneficial effects of weight loss on thrombosis.