Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Apr;42(2):146-54.
doi: 10.1590/S1806-37562016042020068.

New anticoagulants for the treatment of venous thromboembolism

[Article in English, Portuguese]
Caio Julio Cesar Dos Santos Fernandes  1 , José Leonidas Alves Júnior  1 , Francisca Gavilanes  1 , Luis Felipe Prada  1 , Luciana Kato Morinaga  1 , Rogerio Souza  1
Affiliations
Review

New anticoagulants for the treatment of venous thromboembolism

[Article in English, Portuguese]
Caio Julio Cesar Dos Santos Fernandes et al. J Bras Pneumol. 2016 Apr.

Abstract
in English, Portuguese

Worldwide, venous thromboembolism (VTE) is among the leading causes of death from cardiovascular disease, surpassed only by acute myocardial infarction and stroke. The spectrum of VTE presentations ranges, by degree of severity, from deep vein thrombosis to acute pulmonary thromboembolism. Treatment is based on full anticoagulation of the patients. For many decades, it has been known that anticoagulation directly affects the mortality associated with VTE. Until the beginning of this century, anticoagulant therapy was based on the use of unfractionated or low-molecular-weight heparin and vitamin K antagonists, warfarin in particular. Over the past decades, new classes of anticoagulants have been developed, such as factor Xa inhibitors and direct thrombin inhibitors, which significantly changed the therapeutic arsenal against VTE, due to their efficacy and safety when compared with the conventional treatment. The focus of this review was on evaluating the role of these new anticoagulants in this clinical context.

O tromboembolismo venoso (TEV) está entre as principais causas de morte por doenças cardiovasculares no mundo, atrás apenas do infarto agudo do miocárdio e do acidente vascular cerebral. O TEV possui espectro de apresentação que vai desde a trombose venosa profunda até o tromboembolismo pulmonar agudo, de acordo com gravidade crescente de acometimento, sendo seu tratamento baseado na anticoagulação plena dos pacientes. Há muitas décadas, sabe-se que a anticoagulação interfere diretamente na mortalidade associada ao TEV. Até o início deste século a terapia anticoagulante se baseava no uso de heparina, em suas formas não fracionada ou de baixo peso molecular, e de antagonistas da vitamina K, principalmente a varfarina. Ao longo das últimas décadas, foram desenvolvidos novas classes de medicamentos anticoagulantes, inibidores do fator Xa e inibidores diretos da trombina, que mudaram significativamente o arsenal terapêutico do TEV, em função de suas características de eficácia e segurança em relação ao tratamento convencional, sendo o foco principal de esta revisão avaliar seu papel neste contexto clínico.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Anticoagulation cascade with the sites of action of the anticoagulants.
See this image and copyright information in PMC

References

    1. Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008;28(3):370–372. doi: 10.1161/ATVBAHA.108.162545. - DOI - PMC - PubMed
    1. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG. Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98(4):756–764. doi: 10.1160/th07-03-0212. - DOI - PubMed
    1. Andrade Ede O, Bindá FA, Silva AM, Costa TD, Fernandes MC, Fernandes MC. Risk factors and prophylaxis for venous thromboembolism in hospitals in the city of Manaus, Brazil. J Bras Pneumol. 2009;35(2):114–121. - PubMed
    1. Biss TT, Brandão LR, Kahr WH, Chan AK, Williams S. Clinical features and outcome of pulmonary embolism in children. Br J Haematol. 2008;142(5):808–818. doi: 10.1111/j.1365-2141.2008.07243.x. - DOI - PubMed
    1. Konstantinides S, Torbicki A. Management of venous thrombo-embolism: an update. Eur Heart J. 2014;35(41):2855–2863. doi: 10.1093/eurheartj/ehu243. - DOI - PubMed