PMID- 28593681
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20210109
IS  - 1365-2125 (Electronic)
IS  - 0306-5251 (Print)
IS  - 0306-5251 (Linking)
VI  - 83
IP  - 11
DP  - 2017 Nov
TI  - Initial anticoagulation in patients with pulmonary embolism: thrombolysis, 
      unfractionated heparin, LMWH, fondaparinux, or DOACs?
PG  - 2356-2366
LID - 10.1111/bcp.13340 [doi]
AB  - The initial treatment of haemodynamically stable patients with pulmonary embolism 
      (PE) has dramatically changed since the introduction of low molecular weight 
      heparins (LMWHs). With the recent discovery of the direct oral anticoagulant 
      drugs (DOACs), initial treatment of PE will be simplified even further. In 
      several large clinical trials it has been demonstrated that DOACs are not 
      inferior to standard therapy for the initial treatment of PE, and because of 
      their practicability they are becoming the agents of first choice. However, many 
      relative contraindications to DOACs were exclusion criteria in the clinical 
      trials. Therefore, LMWHs will continue to play an important role in initial PE 
      treatment and in some cases there still is a role for unfractionated heparin 
      (UFH). In this review we will give an overview of the biophysical, 
      pharmacokinetic and pharmacodynamic properties of anticoagulants currently 
      available for the initial management of PE. In addition, we will provide a 
      comprehensive overview of the indications for the use of UFH, LMWHs and DOACs in 
      the initial management of PE from a pharmacokinetic/-dynamic point of view.
CI  - (c) 2017 The British Pharmacological Society.
FAU - Leentjens, Jenneke
AU  - Leentjens J
AUID- ORCID: 0000-0003-3356-3910
AD  - Department of Internal Medicine and Pharmacology-Toxicology, Radboud University 
      Nijmegen Medical Center, Nijmegen, The Netherlands.
FAU - Peters, Mike
AU  - Peters M
AD  - VU University Medical Center, Amsterdam, The Netherlands.
FAU - Esselink, Anne C
AU  - Esselink AC
AD  - Department of Internal Medicine and Pharmacology-Toxicology, Radboud University 
      Nijmegen Medical Center, Nijmegen, The Netherlands.
FAU - Smulders, Yvo
AU  - Smulders Y
AD  - VU University Medical Center, Amsterdam, The Netherlands.
FAU - Kramers, Cornelis
AU  - Kramers C
AD  - Department of Internal Medicine and Pharmacology-Toxicology, Radboud University 
      Nijmegen Medical Center, Nijmegen, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170709
PL  - England
TA  - Br J Clin Pharmacol
JT  - British journal of clinical pharmacology
JID - 7503323
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Polysaccharides)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Acute Disease/mortality/therapy
MH  - Anticoagulants/*pharmacology/therapeutic use
MH  - Blood Coagulation/*drug effects
MH  - Clinical Trials as Topic
MH  - Fibrinolytic Agents/*pharmacology/therapeutic use
MH  - Fondaparinux
MH  - Hemodynamics/*drug effects
MH  - Heparin, Low-Molecular-Weight/pharmacology/therapeutic use
MH  - Humans
MH  - Polysaccharides/pharmacology/therapeutic use
MH  - Pulmonary Embolism/*drug therapy/mortality
MH  - Treatment Outcome
PMC - PMC5651323
OTO - NOTNLM
OT  - DOAC
OT  - LMWH
OT  - anticoagulation
OT  - pulmonary embolism
OT  - unfractionated heparin
EDAT- 2017/06/09 06:00
MHDA- 2018/06/13 06:00
PMCR- 2018/11/01
CRDT- 2017/06/09 06:00
PHST- 2017/01/02 00:00 [received]
PHST- 2017/05/13 00:00 [revised]
PHST- 2017/05/30 00:00 [accepted]
PHST- 2017/06/09 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
PHST- 2017/06/09 06:00 [entrez]
PHST- 2018/11/01 00:00 [pmc-release]
AID - BCP13340 [pii]
AID - 10.1111/bcp.13340 [doi]
PST - ppublish
SO  - Br J Clin Pharmacol. 2017 Nov;83(11):2356-2366. doi: 10.1111/bcp.13340. Epub 2017 
      Jul 9.