New oral anticoagulants for thromboprophylaxis after total hip or knee arthroplasty.
Patients undergoing total hip or knee arthroplasty are at increased risk of venous thromboembolism (VTE). The long-term sequelae of VTE, such as post-thrombotic syndrome or pulmonary hypertension, can be debilitating with severe morbidity. Conventional anticoagulants have several short-comings: for example, warfarin requires regular coagulation monitoring and low-molecular-weight heparins are inconvenient to use because they require subcutaneous administration. The development of new anticoagulants has focused on 2 classes of compounds: direct thrombin inhibitors and direct factor Xa inhibitors. These new oral agents have shown efficacy in large randomized clinical trials and offer new, more convenient options for anticoagulation.
Friedman
Richard J
RJ
Department of Orthopaedic Surgery, Roper Hospital, and Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D015195:Drug Design; D065427:Factor Xa Inhibitors; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011322:Primary Prevention; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D013917:Thrombin / Q000037:antagonists & inhibitors; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D013917:Thrombin