Perioperative venous thromboembolic disease and the emerging role of the novel oral anticoagulants: An analysis of the implications for perioperative management.
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Date
2015-10
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Abstract
Venous thromboembolism includes 2 inter-related conditions: Deep venous thrombosis and pulmonary
embolism. Heparin and low-molecular-weight heparin followed by oral anticoagulation with vitamin K agonists
is the first line and current accepted standard therapy with good efficacy. However, this therapeutic strategy has
many limitations including the significant risk of bleeding and drug, food and disease interactions that require
frequent monitoring. Dabigatran, rivaroxaban, apixaban, and edoxaban are the novel oral anticoagulants
that are available for use in stroke prevention in atrial fibrillation and for the treatment and prevention of
venous thromboembolism (HYPERLINK\l "1). Recent prospective randomized trials comparing the NOACs
with warfarin have shown similar efficacy between the treatment strategies but fewer bleeding episodes
with the NOACs. This paper presents an evidence-based review describing the efficacy and safety of the
new anticoagulants compared to warfarin.
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Keywords
Apixaban, Dabigatran, Edoxaban, Novel oral anticoagulants, Rivaroxaban, Venous
Citation
Mookadam Martina, Shamoun Fadi E, Ramakrishna Harish, Obeid Hiba, Rife Renee L, Farouk Mookadam. Perioperative venous thromboembolic disease and the emerging role of the novel oral anticoagulants: An analysis of the implications for perioperative management. Annals of Cardiac Anaesthesia. 2015 Oct; 18(4): 517-527.