PMID- 12232817
OWN - NLM
STAT- MEDLINE
DCOM- 20030307
LR  - 20181130
IS  - 0094-6176 (Print)
IS  - 0094-6176 (Linking)
VI  - 28 Suppl 3
DP  - 2002 Aug
TI  - State of the art--a journey through the world of antithrombotic therapy.
PG  - 3-11
AB  - The introduction of low-molecular-weight heparins (LMWHs) has contributed to 
      major improvements in the management of venous thromboembolism (VTE). The LMWHs 
      have been shown to be as effective as, and safer than, unfractionated heparin 
      (UFH) in the prevention and treatment of VTE, and their use is included as a 
      grade 1A recommendation in the Sixth American College of Chest Physicians 
      Guidelines. Important practical disadvantages of treatment with UFH are the need 
      for extended hospital stays and frequent monitoring of coagulation levels. In 
      comparison, LMWHs offer convenient and cost-effective prophylaxis and treatment 
      of VTE on an outpatient basis. The LMWHs have also had a major impact on the 
      management of arterial thromboembolism. In patients with acute coronary syndromes 
      (unstable angina and non-ST-segment elevation myocardial infarction), enoxaparin 
      has demonstrated sustained clinical improvements in major ischemic outcomes 
      compared with UFH. Antiplatelet agents have also contributed significantly to the 
      development of effective antithrombotic therapy. Aspirin is the best known 
      antiplatelet agent and has heretofore been the mainstay of antiplatelet therapy 
      in unstable angina. New data indicate that combination therapy with aspirin and a 
      novel thienopyridine, clopidogrel, may further improve outcomes in this 
      indication.
FAU - Turpie, Alexander G G
AU  - Turpie AG
AD  - Department of Medicine, HHS General Hospital, McMaster Clinic, Hamilton, Ontario, 
      Canada. turpiea@mcmaster.ca
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Thromb Hemost
JT  - Seminars in thrombosis and hemostasis
JID - 0431155
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Ambulatory Care
MH  - Arterial Occlusive Diseases/drug therapy
MH  - Aspirin/therapeutic use
MH  - Clopidogrel
MH  - Coronary Disease/drug therapy
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Heart Failure/complications
MH  - Hemorrhage/chemically induced
MH  - Heparin, Low-Molecular-Weight/adverse effects/therapeutic use
MH  - Humans
MH  - Orthopedic Procedures
MH  - Platelet Aggregation Inhibitors/adverse effects/therapeutic use
MH  - Postoperative Complications/drug therapy/prevention & control
MH  - Practice Guidelines as Topic
MH  - Recurrence
MH  - Respiratory Insufficiency/complications
MH  - Thromboembolism/drug therapy/prevention & control
MH  - Thrombolytic Therapy
MH  - Thrombophlebitis/drug therapy/prevention & control
MH  - Thrombosis/*drug therapy/epidemiology/prevention & control
MH  - Ticlopidine/*analogs & derivatives/therapeutic use
RF  - 40
EDAT- 2002/09/17 10:00
MHDA- 2003/03/08 04:00
CRDT- 2002/09/17 10:00
PHST- 2002/09/17 10:00 [pubmed]
PHST- 2003/03/08 04:00 [medline]
PHST- 2002/09/17 10:00 [entrez]
AID - 10.1055/s-2002-34080 [doi]
PST - ppublish
SO  - Semin Thromb Hemost. 2002 Aug;28 Suppl 3:3-11. doi: 10.1055/s-2002-34080.