PMID- 16912250
OWN - NLM
STAT- MEDLINE
DCOM- 20061019
LR  - 20060830
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 40
IP  - 9
DP  - 2006 Sep
TI  - Choosing the appropriate antithrombotic agent for the prevention and treatment of 
      VTE: a case-based approach.
PG  - 1558-71
AB  - OBJECTIVE: To review the risk of venous thromboembolism (VTE) in various patient 
      populations and evaluate the agents available for the prevention and treatment of 
      VTE using a case-based approach. DATA SOURCES: A MEDLINE search (1995-July 2006) 
      was conducted to identify relevant literature. Additional references were 
      reviewed from selected articles. STUDY SELECTION AND DATA EXTRACTION: Articles 
      related to the prevention of VTE in orthopedic surgery, general surgery, and 
      medically ill patients, as well as the treatment of VTE, were reviewed. DATA 
      SYNTHESIS: Pharmacologic options for the prevention and treatment of VTE include 
      warfarin, unfractionated heparin (UFH), low-molecular-weight heparins (LMWH), and 
      fondaparinux. Current guidelines support the use of warfarin, LMWH, or 
      fondaparinux for VTE prophylaxis following lower limb major orthopedic surgery. 
      For VTE prophylaxis in hospitalized medical patients or patients undergoing 
      general surgery, use of UFH and LMWH is supported; however, recent data on 
      fondaparinux suggest that it is also effective in these patient populations. The 
      use of UFH or LMWH (both in conjunction with warfarin) for treatment of acute 
      deep venous thrombosis or nonmassive pulmonary embolism is recommended. Recent 
      data suggest that fondaparinux (in conjunction with warfarin) is also effective 
      for the treatment of VTE. A variety of pharmacokinetic, pharmacodynamic, and 
      pharmacoeconomic factors differentiate each agent for the various indications. 
      CONCLUSIONS: Currently, a "one-size-fits-all" anticoagulant is not available for 
      treatment of VTE. A variety of patient factors, including type of surgery, 
      medical indication, thrombotic risk factors, bleeding risk, history of 
      heparin-induced thrombocytopenia, and a variety of comorbid conditions can affect 
      the safety, efficacy, and selection of appropriate VTE therapy.
FAU - Nutescu, Edith A
AU  - Nutescu EA
AD  - Antithrombosis Center, Department of Pharmacy Practice, College of Pharmacy, The 
      University of Illinois at Chicago, Chicago, IL 60612-7230, USA. enutescu@uic.edu
FAU - Wittkowsky, Ann K
AU  - Wittkowsky AK
FAU - Dobesh, Paul P
AU  - Dobesh PP
FAU - Hawkins, David W
AU  - Hawkins DW
FAU - Dager, William E
AU  - Dager WE
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20060815
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Aged
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Embolism/*drug therapy/*prevention & control
MH  - Thromboembolism/drug therapy/prevention & control
MH  - Venous Thrombosis/*drug therapy/*prevention & control
RF  - 98
EDAT- 2006/08/17 09:00
MHDA- 2006/10/20 09:00
CRDT- 2006/08/17 09:00
PHST- 2006/08/17 09:00 [pubmed]
PHST- 2006/10/20 09:00 [medline]
PHST- 2006/08/17 09:00 [entrez]
AID - aph.1G577 [pii]
AID - 10.1345/aph.1G577 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2006 Sep;40(9):1558-71. doi: 10.1345/aph.1G577. Epub 2006 Aug 
      15.