Cardiovascular Medicine

1 pages, 1499 KB

Open AccessEditorial

Research Prize 2012 of the Swiss Heart Foundation

by Swiss Heart Foundation

Cardiovasc. Med. 2012, 15(5), 180; https://doi.org/10.4414/cvm.2012.01670 - 16 May 2012

Cited by 2 | Viewed by 14

The Swiss Heart Foundation awards an annual prize of Swiss Francs 20 000.– for one or several outstanding publications / accepted manuscripts of scientific research in the field of the prevention, diagnosis and/or treatment of cardiovascular diseases [...] Full article

10 pages, 1848 KB

Open AccessReview

Quantification of the Anticoagulatory Effect of Novel Anticoagulants and Management of Emergencies

by Mathilde Gavillet and Anne Angelillo-Scherrer

Cardiovasc. Med. 2012, 15(5), 170; https://doi.org/10.4414/cvm.2012.01668 - 16 May 2012

Cited by 1 | Viewed by 16

Abstract

Novel oral anticoagulants such as dabigatran which specifically target thrombin, and rivaroxaban and apixaban which are activated factor X inhibitors are in the process of being approved for use in Switzerland to lower the risk of stroke in patients with atrial fibrillation. Although there is currently no evidence relevant to the clinical benefit for monitoring anticoagulant intensity of these drugs in routine clinical practice, the need for measuring the anticoagulant effect of the novel anticoagulants may arise in some clinical situations such as: haemorrhage and thrombosis occurring under anticoagulation, an emergency surgery, drug interaction, overdose, impaired renal or liver function compliance monitoring. Furthermore, the effect of novel anticoagulants on routine coagulation tests must be known by the clinician. To date, clinical experience is insufficient to definitively guide the management of emergencies including major bleeding in patients receiving these drugs. Indeed, there is currently no specific antidote available. Fortunately, the half-life of these agents is short, hence treatment interruption is most of the time sufficient to reverse the anticoagulant and clinical effect. In case of life-threatening bleeding, dabigatran can be removed by haemodialysis, and rivaroxaban and apixaban can be antagonised by nonactivated prothrombin complex concentrates. More importantly, preventive attitudes should be placed upfront, before the administration of the novel oral anticoagulant. The prescriber has the responsibility to carefully review possible drug interactions as well as to check renal and liver functions and to provide the patient with an identification card containing personal information, the name of the anticoagulant and treatment indication. In addition, blood cell counts, prothrombin and activated partial thromboplastin times measurements need to be performed before the introduction of the anticoagulation, at least in elderly patients. Full article

7 pages, 1607 KB

Open AccessReview

New Plasmatic Anticoagulants After Acute Coronary Syndromes

by Roberto Corti and Oliver Gaemperli

Cardiovasc. Med. 2012, 15(5), 163; https://doi.org/10.4414/cvm.2012.01666 - 16 May 2012

Viewed by 10

Abstract

Acute coronary syndrome (ACS) and its sequelae continue to be the major cause of death in developed countries resulting in a high toll of fatalities and health care expenditure. The treatment of ACS has dramatically evolved over the last decade leading to a much more aggressive invasive approach in ST- and Non-ST-elevation myocardial infarction. Despite fast reperfusion strategies and optimal anti-atherosclerosis prophylaxis most patients will experience a progression of the disease in the years following diagnosis of coronary heart disease (CHD). Interestingly enough, thrombin generation markedly increases after acute cardiac events and persists for months after clinical stabilisation, suggesting a role of anticoagulant strategies beyond the use in the acute setting. New anticoagulants have been developed with the goal of reducing cardiovascular events in CHD patients while minimising the risk of bleeding. The new oral Xa-inhibitor, rivaroxaban, is the first out of a large selection of new anticoagulant agents to show a statistically significant reduction of a composite endpoint of cardiovascular death, myocardial infarction and stroke in patients with ACS, compared to standard therapy. Full article

8 pages, 1624 KB

Open AccessReview

Novel Oral Anticoagulants for Stroke Prevention in Atrial Fibrillation: A Changing Landscape

by Erik Walter Holy and Jürg-Hans Beer

Cardiovasc. Med. 2012, 15(5), 155; https://doi.org/10.4414/cvm.2012.01667 - 16 May 2012

Viewed by 15

Abstract

Atrial fibrillation is the most common sustained cardiac arrhythmia. Thromboembolic events related to atrial fibrillation result in significant morbidity, mortality and increases in the cost of healthcare. For decades, vitamin Kantagonists have been the mainstay of long-term oral thromboprophylactic anticoagulant therapy. Although these drugs are effective, the narrow therapeutic range, the numerous drug-drug and or drug-food interactions constitute limitations, which have driven the development of new anticoagulant agents. The emerging oral anticoagulant agents are target selective, have more predictable pharmacokinetic and pharmacodynamic parameters and do not require routine monitoring. Recent trials have demonstrated the safety and efficacy of the new direct thrombin inhibitor dabigatran as well as for the selective factor Xa inhibitors rivaroxaban and apixaban. This article reviews the current literature and highlights the challenges associated with the use of new oral anticoagulants for atrial fibrillation in daily practice. Full article

8 pages, 207 KB

Open AccessReview

New Anticoagulants for the Prevention and Therapy of Venous Thromboembolism—A Review

by Nazanin Sédille-Mostafaie and Wolfgang Korte

Cardiovasc. Med. 2012, 15(5), 147; https://doi.org/10.4414/cvm.2012.01665 - 16 May 2012

Viewed by 14

Abstract

Thrombin plays an essential role in haemostasis and thrombosis; therefore, anticoagulant strategies focus on direct or indirect inhibition of thrombin or factor Xa. Over the last 60 years, key players in antithrombotic treatment have been unfractionated heparin and vitamin K antagonists (VAKs), such as coumarin. New oral anticoagulants, with different mechanisms of action and administration, have the potential to promote dramatic changes in the management of patients with venous thromboembolic disease. This review provides an overview of the newer anticoagulants likely to be used in this indication. Full article

4 pages, 1601 KB

Open AccessEditorial

Dawn of a New Era of Oral Anticoagulation

by Jan Steffel

Cardiovasc. Med. 2012, 15(5), 143; https://doi.org/10.4414/cvm.2012.01669 - 16 May 2012

Viewed by 15

Abstract

Ever since their introduction in the middle of the 20^th century, vitamin K antagonists (VKAs) have been used in the treatment and prevention of thromboembolic diseases, especially for venous thromboembolism and stroke prevention in atrial fibrillation (AF) [...] Full article

Journal Menu

Journal Browser

Cardiovasc. Med., Volume 15, Issue 5 (05 2012) – 6 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI