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
Print ISBN9780470319383
Authors, ,
Edition1st edition
Subjects:Cardiovascular medicine
Thema 1.1:MJD
123Library ID:3486

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 Therapy3
Abbreviations and Acronyms13
Chapter 1 Thrombosis and Antithrombotics in Vascular Disease19
1.1 The Burden of Thrombosis19
1.2 Essential components of thrombosis19
1.3 Thrombosis in the acute ischemic syndromes23
1.4 Venous thromboembolic disease24
1.5 The ideal antithrombotic agent28
Chapter 2 Aspirin31
2.1 Introduction31
2.2 Pharmacology31
2.3 Clinical uses of aspirin33
2.4 Conclusions49
Chapter 3 Thienopyridines – Ticlopidine and Clopidogrel55
3.1 Introduction55
3.2 Pharmacology55
3.3 Clinical uses of the thienopyridines59
3.4 Conclusions85
Chapter 4 Platelet Glycoprotein IIb/IIIa Inhibitors95
4.1 Introduction95
4.2 GP IIb/IIIa receptor inhibitors96
4.3 GP IIb/IIIa inhibitors during percutaneous coronary revascularization98
4.4 GP IIb/IIIa inhibitors in the management of non-st-elevation ACS105
4.5 GP IIb/IIIa inhibitors in the management of acute STEMI109
4.6 Safety of GP IIb/IIIa inhibitors112
4.7 Summary114
Chapter 5 Unfractionated Heparin121
5.1 Introduction121
5.2 Pharmacology122
5.3 Clinical uses of UH125
5.4 Clinical considerations136
5.5 Conclusions138
Chapter 6 Low-Molecular-Weight Heparins147
6.1 Introduction147
6.2 Comparisons between UH and LMWH147
6.3 Clinical uses of LMWH151
6.4 Conclusions170
Chapter 7 Direct Thrombin Inhibitors179
7.1 Introduction179
7.2 Overview of DTIs181
7.3 Clinical uses of DTIs184
7.4 Summary194
Chapter 8 Fibrinolytic agents199
8.1 Introduction199
8.2 Fibrinolytic agents for STEMI199
8.3 Fibrinolytics for VTE213
8.4 Conclusions216
Chapter 9 Acute ST-Segment-Elevation Myocardial Infarction223
9.1 Introduction223
9.2 Definitive therapy224
9.3 Adjunctive therapy231
9.4 Recommendations239
9.5 Conclusions243
Chapter 10 Acute Coronary Syndromes: Unstable Angina / Non-ST-Segment-Elevation Myocardial Infarction (NSTE ACS)251
10.1 Introduction251
10.2 Antithrombotic approach to patients with ACS/NSTEMI252
10.3 Early invasive versus early conservative strategies268
10.4 Recommendations270
10.5 Conclusions272
Chapter 11 Anticoagulation Strategies for Patients Undergoing Percutaneous Coronary Intervention277
11.1 Introduction277
11.2 Antiplatelet therapy277
11.3 Antithrombotic therapy284
11.4 Special populations288
11.5 Recommendations291
11.6 Conclusions293
Chapter 12 Venous Thromboembolic Disease301
12.1 Introduction301
12.2 Risk of VTE301
12.3 Prevention of VTE304
12.4 Treatment of VTE312
12.5 Conclusions321
Chapter 13 Heparin-Induced Thrombocytopenia335
13.1 Introduction335
13.2 Incidence335
13.3 Pathogenesis339
13.4 Clinical manifestations342
13.5 Diagnosis346
13.6 Prevention348
13.7 Treatment348
13.8 Conclusions353