The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants.
As the risk factors for thrombosis are becoming better understood, so is the need for anticoagulation. The inherent difficulties with warfarin are such that a low-molecular-weight heparin (LMWH) is often the key therapeutic. However, there are several different species of LMWH available to the practitioner, which leads to the need for an objective guide. New agents are coming onto the marketplace, and these may supersede both warfarin and the heparins. The current report will review the biochemistry and pharmacology of different LWMHs and identify which are more suitable for the different presentations of venous thromboembolism. It will conclude with a brief synopsis of new agents which may supersede warfarin and heparin.
Blann
Andrew D
AD
University Department of Medicine, City Hospital, Birmingham, UK. a.blann@bham.ac.uk
Khoo
Chee W
CW
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
J Thromb Haemost. 2005 Mar;3(3):514-21
15748242
Lancet. 2007 Sep 15;370(9591):949-56
17869635
Chest. 2008 Jun;133(6 Suppl):71S-109S
18574259
Eur Heart J. 1998 Aug;19(8):1239-48
9740346
N Engl J Med. 1995 Jun 22;332(25):1661-5
7760866
N Engl J Med. 2006 Apr 6;354(14):1464-76
16537663
BMJ. 2002 Oct 19;325(7369):887-90
12386044
N Engl J Med. 2008 Jun 26;358(26):2765-75
18579811
Lancet. 1986 Dec 6;2(8519):1293-6
2878173
Lancet. 1966 Mar 19;1(7438):621-3
4159671
Chest. 1992 Oct;102(4 Suppl):337S-351S
1327666
J Biol Chem. 1979 Apr 25;254(8):2902-13
429327
J Thromb Haemost. 2008 Aug;6(8):1313-8
18541000
Circulation. 2003 Jun 17;107(23 Suppl 1):I4-8
12814979
Clin Cardiol. 2000 Jan;23 Suppl 1:I4-7
10680037
Br J Clin Pharmacol. 2007 Sep;64(3):292-303
17506785
Chest. 2001 Jan;119(1 Suppl):176S-193S
11157648
Br J Haematol. 1979 Apr;41(4):573-83
435404
Int J Clin Pract. 2009 Apr;63(4):630-41
19222611
Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):380-6
18296593
N Engl J Med. 2008 Jun 26;358(26):2776-86
18579812
Arch Intern Med. 1985 Jun;145(6):1070-2
4004433
Thromb Haemost. 1990 Oct 22;64(2):286-9
2270535
Ann Intern Med. 1984 May;100(5):646-50
6712030
N Engl J Med. 1975 May 15;292(20):1046-50
1091856
J Thromb Haemost. 2005 Jan;3(1):103-11
15634273
Lancet. 2008 Jul 5;372(9632):31-9
18582928
Chest. 2008 Jun;133(6 Suppl):234S-256S
18574267
J Thromb Haemost. 2005 Aug;3(8):1554-60
16102019
Blood. 2008 Sep 15;112(6):2242-7
18621928
Arch Intern Med. 1995 Mar 27;155(6):601-7
7887755
Circulation. 2007 Jul 31;116(5):552-60
17664384
Lancet. 1960 Jun 18;1(7138):1309-12
13797091
N Engl J Med. 1986 Oct 30;315(18):1109-14
3531862
Blood. 2002 Apr 15;99(8):2720-5
11929758
J Thromb Haemost. 2007 Dec;5(12):2368-75
17868430
Annu Rev Med. 1999;50:129-47
10073268
JAMA. 1979 Jun 1;241(22):2417-8
439319
Am J Clin Pathol. 1988 Jan;89(1):19-23
3337049
Drugs Today (Barc). 2007 Mar;43(3):129-36
17380210
Br J Haematol. 2006 Apr;133(1):19-34
16512825
Biochem J. 1935 Aug;29(8):1817-30
16745848
Arch Intern Med. 2002 Sep 9;162(16):1833-40
12196081
J Thromb Haemost. 2005 Aug;3(8):1611-7
16102026
Br Med J (Clin Res Ed). 1982 Feb 6;284(6313):375-9
6800465
N Engl J Med. 1995 May 18;332(20):1330-5
7715641
Thromb Haemost. 2009 Jan;101(1):68-76
19132191
N Engl J Med. 1992 Nov 19;327(21):1485-9
1406880
J Thromb Haemost. 2007 Nov;5(11):2178-85
17764540
BMJ. 1994 Jul 30;309(6950):299-304
8086867
BMJ. 2002 Oct 26;325(7370):948-50
12399348
Circulation. 1998 Jan 27;97(3):251-6
9462526
Clin Pharmacol Ther. 1981 Mar;29(3):387-93
7471609
Ann N Y Acad Sci. 1989;556:245-54
2544126
N Engl J Med. 1996 Mar 14;334(11):682-7
8594426
Ann Intern Med. 1999 May 18;130(10):800-9
10366369
Thorax. 2003 Jun;58(6):470-83
12775856
Br J Radiol. 1973 Jul;46(547):548-50
4718297
Semin Thromb Hemost. 1985 Jan;11(1):13-6
2579436
CRC Crit Rev Clin Lab Sci. 1979;10(3):247-74
380902
J Thromb Haemost. 2003 Jul;1(7):1464-70
12871281
J Clin Invest. 1980 Jan;65(1):64-73
6243142
Circulation. 2003 Jun 17;107(23 Suppl 1):I9-16
12814980
N Engl J Med. 1997 Sep 4;337(10):657-62
9280815
N Engl J Med. 1996 Mar 14;334(11):677-81
8594425
Oncologist. 2007 Nov;12(11):1361-70
18055857
Am J Med. 1996 Mar;100(3):269-77
8629671
Circulation. 1959 Jan;19(1):79-86
13619024
J Thromb Haemost. 2003 Jul;1(7):1471-8
12871282
Thromb Haemost. 2009 Jan;101(1):2-4
19132179
Haemostasis. 1993 Mar;23 Suppl 1:141-9
7684350
J Intern Med. 2008 Jan;263(1):52-60
18088252
Circulation. 2007 Jul 10;116(2):180-7
17576867
Curr Opin Pulm Med. 2003 Sep;9(5):351-5
12904702
Curr Opin Investig Drugs. 2008 Sep;9(9):1020-33
18729009
Thromb Haemost. 2003 Aug;90(2):267-71
12888874
AMA Arch Surg. 1958 Feb;76(2):219-25; discussion 225-7
13497418
Chest. 2001 Jan;119(1 Suppl):64S-94S
11157643
N Engl J Med. 1997 Sep 4;337(10):663-9
9278462
Annu Rev Biochem. 1978;47:385-417
354500
Am J Cardiol. 2007 Nov 1;100(9):1419-26
17950801
N Engl J Med. 1991 May 30;324(22):1565-74
2027360
Curr Pharm Des. 2005;11(4):415-9
15725062
Curr Opin Pulm Med. 2002 Sep;8(5):405-12
12172444
BMJ. 2006 Jan 28;332(7535):215-9
16439400
N Engl J Med. 2003 Jul 10;349(2):146-53
12853587
J Arthroplasty. 2009 Jan;24(1):1-9
18534438
J Thromb Haemost. 2003 Jul;1(7):1456-63
12871280
Chest. 2001 Jan;119(1 Suppl):283S-299S
11157655
J Thromb Haemost. 2004 Sep;2(9):1573-80
15333033
J Thromb Haemost. 2008 May;6(5):820-9
18315548
Blood. 2008 May 15;111(10):4871-9
18309033
Clin Pharmacol Ther. 2005 Oct;78(4):412-21
16198660
Blood Coagul Fibrinolysis. 2002 Dec;13(8):657-70
12441904