Management Strategies in Antithrombotic Therapy

Arman Askari, Michael Lincoff, Adrian Messerli

Management Strategies in Antithrombotic Therapy
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Product details

Published11th March 2008
ISBN9780470518144
Price£123.69
Print ISBN9780470319383
eISBN9780470518144
Authors, ,
PublisherWiley-Interscience
Edition1st edition
Pages372
LanguageEnglish
Subjects:Cardiovascular medicine
BIC:MJD
BISAC:MED010000
123Library ID:3486
Format:eBook

eBook Overview

Intravascular thrombus formation remains one of the most significant problems in cardiovascular medicine. It underlies the clinical presentation of acute coronary syndromes, including unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction.

More and more individuals are stricken with an acute MI and undergo a percutaneous coronary intervention (PCI). Several reasons apply, including an increasingly aged population, the growing burden of chronic risk factors such as diabetes, obesity, sedentary behaviour, and improvements in early recognition and intervention. Thrombus formation also results in substantial morbidity and mortality. Despite significant advances in prevention and treatment of venous thromboembolism, pulmonary embolism remains a common preventable cause of hospital deaths. Implementing the most appropriate, and safe, anticoagulation therapy across the spectrum of cardiovascular disease in the presence of a wide range of other risk factors remains a challenge.

Written by leading authorities in the field, Management Strategies in Antithrombotic Therapy offers a comprehensive review of antithrombotic therapy, including the latest therapies, risk factors and evidence-based strategy. The book acquaints readers with the data behind the commonly used antithrombotic agents and assists them in formulating a sound, evidence-based therapeutic strategy appropriate for each patient.

This book is an invaluable resource for all postgraduate students and specialist physicians in cardiovascular medicine, cardiac and vascular surgery, and critical care.

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Table of Contents

Management Strategies in Antithrombotic Therapy
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3
Contents9
Abbreviations and Acronyms13
Preface17
Chapter 1 Thrombosis and Antithrombotics in Vascular Disease
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19
1.1 The Burden of Thrombosis
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19
1.2 Essential components of thrombosis
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19
1.3 Thrombosis in the acute ischemic syndromes
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23
1.4 Venous thromboembolic disease
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24
1.5 The ideal antithrombotic agent
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28
Chapter 2 Aspirin
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31
2.1 Introduction
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31
2.2 Pharmacology
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31
2.3 Clinical uses of aspirin
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33
2.4 Conclusions
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49
Chapter 3 Thienopyridines – Ticlopidine and Clopidogrel
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55
3.1 Introduction
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55
3.2 Pharmacology
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55
3.3 Clinical uses of the thienopyridines
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59
3.4 Conclusions
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85
Chapter 4 Platelet Glycoprotein IIb/IIIa Inhibitors
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95
4.1 Introduction
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95
4.2 GP IIb/IIIa receptor inhibitors
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96
4.3 GP IIb/IIIa inhibitors during percutaneous coronary revascularization
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98
4.4 GP IIb/IIIa inhibitors in the management of non-st-elevation ACS
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105
4.5 GP IIb/IIIa inhibitors in the management of acute STEMI
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109
4.6 Safety of GP IIb/IIIa inhibitors
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112
4.7 Summary
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114
Chapter 5 Unfractionated Heparin
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121
5.1 Introduction
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121
5.2 Pharmacology
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122
5.3 Clinical uses of UH
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125
5.4 Clinical considerations
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136
5.5 Conclusions
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138
Chapter 6 Low-Molecular-Weight Heparins
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147
6.1 Introduction
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147
6.2 Comparisons between UH and LMWH
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147
6.3 Clinical uses of LMWH
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151
6.4 Conclusions
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170
Chapter 7 Direct Thrombin Inhibitors
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179
7.1 Introduction
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179
7.2 Overview of DTIs
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181
7.3 Clinical uses of DTIs
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184
7.4 Summary
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194
Chapter 8 Fibrinolytic agents
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199
8.1 Introduction
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199
8.2 Fibrinolytic agents for STEMI
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199
8.3 Fibrinolytics for VTE
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213
8.4 Conclusions
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216
Chapter 9 Acute ST-Segment-Elevation Myocardial Infarction
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223
9.1 Introduction
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223
9.2 Definitive therapy
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224
9.3 Adjunctive therapy
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231
9.4 Recommendations
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239
9.5 Conclusions
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243
Chapter 10 Acute Coronary Syndromes: Unstable Angina / Non-ST-Segment-Elevation Myocardial Infarction (NSTE ACS)
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251
10.1 Introduction
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251
10.2 Antithrombotic approach to patients with ACS/NSTEMI
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252
10.3 Early invasive versus early conservative strategies
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268
10.4 Recommendations
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270
10.5 Conclusions
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272
Chapter 11 Anticoagulation Strategies for Patients Undergoing Percutaneous Coronary Intervention
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277
11.1 Introduction
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277
11.2 Antiplatelet therapy
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277
11.3 Antithrombotic therapy
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284
11.4 Special populations
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288
11.5 Recommendations
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291
11.6 Conclusions
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293
Chapter 12 Venous Thromboembolic Disease
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301
12.1 Introduction
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301
12.2 Risk of VTE
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301
12.3 Prevention of VTE
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304
12.4 Treatment of VTE
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312
12.5 Conclusions
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321
Chapter 13 Heparin-Induced Thrombocytopenia
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335
13.1 Introduction
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335
13.2 Incidence
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335
13.3 Pathogenesis
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339
13.4 Clinical manifestations
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342
13.5 Diagnosis
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346
13.6 Prevention
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348
13.7 Treatment
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348
13.8 Conclusions
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353
Index361
Plates
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369