[Hemorrhagic complications of anticoagulants in angiology].
Anticoagulants (unfractionated heparin UFH, low-molecular-weight heparins LMWH, coumarins) are mainly used to prevent (prophylactic dosage) or treat (therapeutic dosage) deep-vein thrombosis and pulmonary embolism. After surgery, prophylactic regimens of UFH and LMWH induce a doubling of the hemorrhagic risk which is observed under placebo. At therapeutic dosages, UFH and LMWH are associated with a risk of major bleeding of about 5%, with a trend favouring LMWH for a similar antithrombotic efficacy. At therapeutic levels, coumarins induce major bleeding at a rate of approximately 1%/month. This figure is proportional to the duration and the intensity (INR) of the treatment. It appears to be the major determinant of an optimal duration of anticoagulant treatment following deep-vein thrombosis.
Bounameaux
H
H
Division d'Angiologie et d'Hémostase, Hôpital Cantonal Universitaire, Genève, Suisse.
D015110:4-Hydroxycoumarins; D000925:Anticoagulants / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D000075202:Contraindications; D006470:Hemorrhage / Q000139:chemically induced*; D006493:Heparin; D006801:Humans; D007192:Indenes; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012307:Risk Factors; D013924:Thrombophlebitis / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D007192:Indenes; C011664:antivitamins K; D014812:Vitamin K; D006493:Heparin
Les complications hémorragiques des anticoagulants en angiologie.