Tun Han Naung, Kyaw May Thu, Rafflenbeul Erik, Suástegui Xiuhtlaulli López
Larner College of Medicine, University of Vermont Burlington, VT, US.
Heart and Vascular Centre, Victoria Hospital Yangon, Myanmar.
Eur Cardiol. 2022 May 13;17:e11. doi: 10.15420/ecr.2021.55. eCollection 2022 Feb.
Venous thromboembolism (VTE) is one of the leading causes of post-operative morbidity and mortality. Over previous decades, heparin and warfarin were the predominant therapeutic options for post-operative thromboprophylaxis. However, their use is limited by drawbacks including a narrow therapeutic range, numerous food and drug interactions, and the need for regular monitoring for dose adjustments. Recently, direct oral anticoagulants (DOACs), such as dabigatran etexilate (a direct thrombin inhibitor) and apixaban, rivaroxaban and edoxaban (direct factor Xa inhibitors), have been developed to overcome these issues. DOACs have shown promising results in Phase III clinical trials for post-operative VTE prophylaxis. This review summarises the pharmacological profile of DOACs and highlights the use of DOACs in post-operative VTE prophylaxis based on the available clinical trial data.
静脉血栓栓塞症(VTE)是术后发病和死亡的主要原因之一。在过去几十年中,肝素和华法林是术后血栓预防的主要治疗选择。然而,它们的使用受到诸多限制,包括治疗窗狭窄、大量食物和药物相互作用以及需要定期监测以调整剂量。最近,已开发出直接口服抗凝剂(DOACs),如达比加群酯(一种直接凝血酶抑制剂)以及阿哌沙班、利伐沙班和依度沙班(直接Xa因子抑制剂),以克服这些问题。DOACs在术后VTE预防的III期临床试验中已显示出有前景的结果。本综述总结了DOACs的药理学概况,并根据现有临床试验数据强调了DOACs在术后VTE预防中的应用。