University of Padua School of Medicine, Cardiology Clinic, Thrombosis Center, Department of Cardiothoracic and Vascular Sciences, Padua, Italy.
Expert Opin Drug Saf. 2012 May;11(3):401-13. doi: 10.1517/14740338.2012.668524. Epub 2012 Mar 6.
Currently used anticoagulants such as unfractionated heparin, low-molecular-weight heparin and vitamin K antagonists, have several drawbacks, mostly related to safety. In this review, we will briefly discuss and compare the safety of anticoagulation therapy with 'old' and new agents.
Safety issues with anticoagulation therapy are mostly related to bleeding. The intensity of anticoagulation is related to the risk of bleeding and thus, for the efficacy not to be affected, must be maintained at the lower effective intensity. Several improvements have been made in the management of anticoagulation therapy; these include monitoring, pathology-based treatment schemes taking into account patient characteristics, patient education and the introduction of anticoagulation centers. Safety of novel anticoagulants is encouraging.
Novel agents have the potential to compete with existing therapy for thromboprophylaxis, treatment and stroke prevention in atrial fibrillation. Promising results have emerged from trials comparing them with existing treatment. Not long from now we will see these new agents in the armamentarium of antithrombotic drugs.
目前使用的抗凝剂，如未分级肝素、低分子量肝素和维生素 K 拮抗剂，存在一些缺点，主要与安全性有关。在这篇综述中，我们将简要讨论和比较抗凝治疗中“旧”和新药物的安全性。
抗凝治疗的安全性问题主要与出血有关。抗凝强度与出血风险有关，因此，为了不影响疗效，必须将其维持在较低的有效强度。在抗凝治疗的管理方面已经进行了一些改进；其中包括监测、基于病理的治疗方案，考虑到患者的特征、患者教育和抗凝中心的引入。新型抗凝剂的安全性令人鼓舞。
新型药物有可能在血栓预防、房颤治疗和中风预防方面与现有治疗方法竞争。与现有治疗方法相比，这些药物的临床试验结果令人鼓舞。不久之后，我们将在抗血栓药物中看到这些新的药物。
