Ramos-Esquivel Allan
Allan Ramos-Esquivel, Department of Pharmacology, School of Medicine, University of Costa Rica, San José 11501-2060, Costa Rica.
World J Methodol. 2015 Dec 26;5(4):212-5. doi: 10.5662/wjm.v5.i4.212.
Thromboembolic disease is a major leading cause of mortality and morbidity in industrialized countries. Currently, the management of these patients is challenging due to the availability of new drugs with proven efficacy and security compared to traditional oral vitamin K antagonists. These compounds are characterized by a predictable pharmacokinetic profile for which blood monitoring is not routinely needed. Nevertheless, some data have suggested inter-patient variability in the anticoagulant effect of these drugs, raising concerns about their effectiveness and safety. Although mass-spectrometry is the gold standard to determine drug plasma concentrations, this method is not widely available in every-day practice and some coagulation assays are commonly used to determine the anticoagulant effect of these drugs. The present review aims to summarize the current knowledge regarding the clinical question of how and when to monitor patients with new anticoagulant oral agents.
在工业化国家，血栓栓塞性疾病是导致死亡和发病的主要原因。目前，与传统口服维生素K拮抗剂相比，新型药物已被证实具有疗效和安全性，这使得这些患者的治疗颇具挑战性。这些化合物具有可预测的药代动力学特征，通常无需进行血液监测。然而，一些数据表明这些药物的抗凝效果存在个体差异，这引发了人们对其有效性和安全性的担忧。虽然质谱分析法是测定药物血浆浓度的金标准，但这种方法在日常实践中并不广泛可用，一些凝血试验通常用于测定这些药物的抗凝效果。本综述旨在总结当前关于如何以及何时监测新型口服抗凝剂患者这一临床问题的相关知识。
