PMID- 25948149
OWN - NLM
STAT- MEDLINE
DCOM- 20160229
LR  - 20150526
IS  - 2567-689X (Electronic)
IS  - 0340-6245 (Linking)
VI  - 113
IP  - 6
DP  - 2015 Jun
TI  - Acute phase treatment of VTE: Anticoagulation, including non-vitamin K antagonist 
      oral anticoagulants.
PG  - 1193-202
LID - 10.1160/TH14-12-1036 [doi]
AB  - The acute phase of venous thromboembolism (VTE) treatment focuses on the prompt 
      and safe initiation of full-dose anticoagulation to decrease morbidity and 
      mortality. Immediate management consists of resuscitation, supportive care, and 
      thrombolysis for patients with haemodynamically significant pulmonary embolism 
      (PE) or limb-threatening deep-vein thrombosis (DVT). Patients with 
      contraindications to anticoagulants are considered for vena cava filters. 
      Disposition for the acute treatment of VTE is then considered based on published 
      risk scores and the patient's social status, as the first seven days carries the 
      highest risk for VTE recurrence, extension and bleeding due to anticoagulation. 
      Next, a review of: immediate and long-term bleeding risk, comorbidities (i. e. 
      active cancer, renal failure, obesity, thrombophilia), medications, patient 
      preference, VTE location and potential for pregnancy should be undertaken. This 
      will help determine the most suitable anticoagulant for immediate treatment. The 
      non-vitamin K antagonist oral anticoagulants (NOACs), including the factor Xa 
      inhibitors apixaban, edoxaban and rivaroxaban as well as the direct-thrombin 
      inhibitor dabigatran, are increasing the convenience of and options available for 
      VTE treatment. Current options for immediate treatment include 
      low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), fondaparinux, 
      apixaban, or rivaroxaban. LMWH or UFH may be continued as monotherapy or 
      transitioned to treatment with a VKA, dabigatran or edoxaban. This review 
      describes the upfront treatment of VTE and the evolving role of NOACs in the 
      contemporary management of VTE.
FAU - Hillis, Christopher M
AU  - Hillis C
FAU - Crowther, Mark A
AU  - Crowther MA
AD  - Mark Crowther, MD, MSc, FRCPC, Rm L208, 50 Charlton Ave East, Hamilton, ON, 
      Canada L8N 4A6, E-mail: crowthrm@mcmaster.ca.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20150507
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
SB  - IM
EIN - Thromb Haemost. 2015 Jul;114(1):210. PMID: 26125661
MH  - Administration, Oral
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Blood Coagulation/*drug effects
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Patient Selection
MH  - Predictive Value of Tests
MH  - Pulmonary Embolism/blood/diagnosis/*drug therapy
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vena Cava Filters
MH  - Venous Thromboembolism/blood/diagnosis/*drug therapy
MH  - Venous Thrombosis/blood/diagnosis/*drug therapy
OTO - NOTNLM
OT  - Clinical trials
OT  - deep-vein thrombosis
OT  - oral anticoagulants
OT  - pulmonary embolism
OT  - venous thrombosis
EDAT- 2015/05/08 06:00
MHDA- 2016/03/02 06:00
CRDT- 2015/05/08 06:00
PHST- 2014/12/14 00:00 [received]
PHST- 2015/03/28 00:00 [accepted]
PHST- 2015/05/08 06:00 [entrez]
PHST- 2015/05/08 06:00 [pubmed]
PHST- 2016/03/02 06:00 [medline]
AID - 14-12-1036 [pii]
AID - 10.1160/TH14-12-1036 [doi]
PST - ppublish
SO  - Thromb Haemost. 2015 Jun;113(6):1193-202. doi: 10.1160/TH14-12-1036. Epub 2015 
      May 7.