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[Problems of long-term therapy with anticoagulants]
1Abteilung für Hämatologie/Hämostaseologie, Universitätsklinik für Innere Medizin I, Wien.
Acta Medica Austriaca
|January 1, 1992
Summary
Oral anticoagulants effectively prevent blood clots in conditions like atrial fibrillation but carry bleeding risks. A lower anticoagulant level (INR 2.0-3.0) is now considered sufficient for preventing venous thromboembolism and cardiac emboli.
Area of Science:
- Cardiology
- Hematology
Context:
- Oral anticoagulants are crucial for preventing thromboembolic events in various cardiovascular conditions.
- Bleeding is a significant side effect, with fatal bleeding risk varying by treatment intensity.
Purpose:
- To review the efficacy and safety of oral anticoagulants.
- To highlight the standardization of prothrombin time measurement using the International Normalized Ratio (INR).
- To discuss recent findings on optimal anticoagulation intensity.
Summary:
- Oral anticoagulants are effective in preventing venous thromboembolism and thromboembolic complications in atrial fibrillation, dilated cardiomyopathy, and prosthetic heart valves.
- International Normalized Ratio (INR) has standardized prothrombin time determination.
- Current evidence suggests an INR range of 2.0 to 3.0 is adequate for preventing venous thromboembolism and cardiac emboli.
Impact:
- The findings support a refined approach to anticoagulation therapy, potentially reducing bleeding complications.
- Future monitoring may involve activation markers of coagulation for more precise management.
- Establishes a benchmark for optimal anticoagulation intensity in specific patient populations.