Burnett Allison E, Mahan Charles E, Vazquez Sara R, Oertel Lynn B, Garcia David A, Ansell Jack
University of New Mexico Hospital Inpatient Antithrombosis Service, University of New Mexico College of Pharmacy, 2211 Lomas Blvd. NE, Albuquerque, NM, 87106, USA.
Presbyterian Healthcare Services, University of New Mexico College of Pharmacy, Albuquerque, NM, USA.
J Thromb Thrombolysis. 2016 Jan;41(1):206-32. doi: 10.1007/s11239-015-1310-7.
Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity and mortality, and an incidence that is expected to double in the next forty years. The advent of direct oral anticoagulants (DOACs) has catalyzed significant changes in the therapeutic landscape of VTE treatment. As such, it is imperative that clinicians become familiar with and appropriately implement new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance for VTE treatment with the DOACs. When possible, guidance statements are supported by existing published evidence and guidelines. In instances where evidence or guidelines are lacking, guidance statements represent the consensus opinion of all authors of this manuscript and are endorsed by the Board of Directors of the Anticoagulation Forum.The authors of this manuscript first developed a list of pivotal practical questions related to real-world clinical scenarios involving the use of DOACs for VTE treatment. We then performed a PubMed search for topics and key words including, but not limited to, apixaban, antidote, bridging, cancer, care transitions, dabigatran, direct oral anticoagulant, deep vein thrombosis, edoxaban, interactions, measurement, perioperative, pregnancy, pulmonary embolism, reversal, rivaroxaban, switching, \thrombophilia, venous thromboembolism, and warfarin to answer these questions. Non- English publications and publications > 10 years old were excluded. In an effort to provide practical information about the use of DOACs for VTE treatment, answers to each question are provided in the form of guidance statements, with the intent of high utility and applicability for frontline clinicians across a multitude of care settings.
静脉血栓栓塞症（VTE）是一种严重的医学病症，具有较高的发病率和死亡率，预计在未来四十年内发病率将翻倍。直接口服抗凝剂（DOACs）的出现催化了VTE治疗领域的重大变革。因此，临床医生必须熟悉并适当地采用新的治疗模式。这份由抗凝论坛发起的手稿为使用DOACs治疗VTE提供了临床指导。在可能的情况下，指导声明以现有的已发表证据和指南为依据。在缺乏证据或指南的情况下，指导声明代表了本手稿所有作者的共识意见，并得到了抗凝论坛董事会的认可。本手稿的作者首先列出了一系列与使用DOACs治疗VTE的实际临床场景相关的关键实用问题。然后，我们在PubMed上搜索了相关主题和关键词，包括但不限于阿哌沙班、解毒剂、桥接治疗、癌症、护理过渡、达比加群、直接口服抗凝剂、深静脉血栓形成、依度沙班、相互作用、检测、围手术期、妊娠、肺栓塞、逆转、利伐沙班、转换、血栓形成倾向、静脉血栓栓塞症和华法林，以回答这些问题。排除非英文出版物和超过10年的出版物。为了提供关于使用DOACs治疗VTE的实用信息，每个问题的答案均以指导声明的形式呈现，旨在为众多护理环境中的一线临床医生提供高度实用和适用的信息。
