ANMCO Position Paper: the use of non-vitamin K dependent new oral anticoagulant(s) in pulmonary embolism therapy and prevention

作者：Enea Iolanda; Roncon Loris; Gulizia Michele Massimo; Azzarito Michele; Becattini Cecilia; Bongarzoni Amedeo; Casazza Franco; Cuccia Claudio; D' Agostino Carlo; Rugolotto Matteo; Vatrano Marco; Vinci Eugenio; Fenaroli Paride; Formigli Dario; Silvestri Paolo; Nardi Federico; Vedovati Maria Cristina; Scherillo Marino

来源：European Heart Journal - Supplements, 2017, 19(D): D293-D308.

DOI：10.1093/eurheartj/sux026

• Pulmonary embolism
• Venous thromboembolism
• New oral anticoagulants (NOACs)
• Prevention
• Therapy

The new oral anticoagulants (NOACs) have radically changed the approach to the treatment and prevention of thromboembolic pulmonary embolism. The authors of this position paper face, in succession, issues concerning NOACs, including (i) their mechanism of action, pharmacodynamics, and pharmacokinetics; (ii) the use in the acute phase with the 'double drug single dose' approach or with 'single drug double dose'; (iii) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; (iv) the encouraging use of NOACs in particular subgroups of patients such as those with cancer, the ones under- or overweight, with renal insufficiency (creatinine clearance > 30 mL/min), the elderly (> 75 years); (v) they propose a possible laboratory clinical pathway for follow-up; and (vi) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications. The authors conclude that the use of NOACs both in the acute phase and in the extended phase is equally effective to conventional therapy and associated with fewer major bleeding events, which make their use in patients at higher risk of recurrences safer.

• 出版日期2017-5
• 单位Perugia