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European Heart Journal Advance Access originally published online on April 10, 2007
European Heart Journal 2007 28(7):880-913; doi:10.1093/eurheartj/ehl492
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Anticoagulants in heart disease: current status and perspectives{ddagger}

Raffaele De Caterina*,{dagger}, Steen Husted{dagger}, Lars Wallentin{dagger}, Giancarlo Agnelli, Fedor Bachmann, Colin Baigent, Jørgen Jespersen, Steen Dalby Kristensen, Gilles Montalescot, Agneta Siegbahn, Freek W.A. Verheugt and Jeffrey Weitz

Italy
Denmark
Sweden
Italy
Switzerland
United Kingdom
Denmark
Denmark
France
Sweden
The Netherlands
Canada

* Corresponding author. Institute of Cardiology, ‘G. d'Annunzio’ University—Chieti, Ospedale S. Camillo de Lellis, Via Forlanini 50, 66100 Chieti, Italy. Tel: +39 0871 415 12; fax: +39 0871 402 817/498217. E-mail address: rdecater@unich.it

{dagger} These authors are the Coordinating Committee. Back

{ddagger} The content of parts of this position paper overlaps with that of the forthcoming guidelines on NSTE-ACS, and unavoidably, some sections are similar, for the sake of consistency, between these documents. Back

The first 150 words of the full text of this article appear below.


   List of Abbreviations
 

ACCPAmerican College of Chest Physicians
ACSacute coronary syndrome(s)
ACTactivated clotting time
AFatrial fibrillation
ALATalanine amino transferase
APCactivated protein C
APSACanisoylated plasminogen streptokinase activator complex
aPTTactivated partial thromboplastin time
ASISactive site-inhibited seven (FVIIa)
ATantithrombin, formerly antithrombin III
CABGcoronary artery bypass graft
CDcluster of differentiation
CDSScomputerized decision support system
CHFchronic heart failure
CrClcreatinine clearance
ECAAEuropean Society of Cardiology
Ffactor
FDAFood and Drug Administration
GFRglomerular filtration rate
GPglycoprotein
GUSTOGlobal Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries
HITheparin-induced thrombocytopenia
ICHintracranial hemorrhage
ILinterleukin
INRInternational Normalized Ratio
ISIInternational Sensitivity Index
ISTHInternational Society on Thrombosis and Haemostasis
LDLlow-density lipoproteins
LMWHlow molecular weight heparin
MImyocardial infarction
MNPTmean normal prothrombin time
NAPC2nematode anticoagulant peptide C2
NYHANew York Heart . . . [Full Text of this Article]


   Preamble: purposes and scope of the task force
 

   Blood coagulation
 
Haemostasis
Arterial thrombosis
Tissue factor
Tissue factor pathway inhibitor
Cellular control of coagulation
Cross-talk between coagulation and inflammation

   Epidemiology of anticoagulant therapy in heart disease
 
Coronary heart disease
Non-valvular atrial fibrillation
Prosthetic heart valves
Heart failure

   Parenteral anticoagulants: general pharmacology
 
Heparin derivatives
Unfractionated heparin
Mechanism of action
Pharmacokinetics
Dosing and monitoring
Side effects
Low molecular weight heparins
Mechanism of action
Pharmacokinetics
Dosing and monitoring
Side effects
Pentasaccharides: fondaparinux and idraparinux
Mechanism of action
Dosing
Monitoring
Side effects
Parenteral direct thrombin inhibitors
Compared pharmacological properties of unfractionated heparin, low-molecular weight heparins, pentasaccharides, and direct thrombin inhibitors

   Vitamin K antagonists: general pharmacology
 
Mechanism of action
Vitamin K anticoagulant therapy: interference with foods and drugs
Laboratory control
Dosing
Point-of-care testing and prothrombin time monitors
Self-management of oral anticoagulation

   Oral direct thrombin inhibitors: general pharmacology
 

   Parenteral anticoagulants: clinical indications
 
Unfractionated heparin
Low molecular weight heparins
Non-ST-elevation acute coronary syndromes
ST-elevation acute myocardial infaction treated with fibrinolytics
Elective percutaneous coronary interventions
Percutaneous coronary interventions in the setting of acute coronary syndromes
Pentasaccharides
Fondaparinux
Idraparinux
Intravenous direct thrombin inhibitors

   Vitamin K antagonists
 
Coronary heart disease
Primary prevention
Acute coronary syndromes
Coronary bypass graft surgery
Percutaneous coronary interventions
Atrial fibrillation
Artificial heart valves
Heart failure

   Oral direct thrombin inhibitors: clinical developments
 

   Oral Factor Xa inhibitors: clinical developments
 

   Bleeding risk and bleeding management during anticoagulant therapy
 
General risk factors for bleeding
Unfractionated heparin and low-molecular weight heparins
Pentasaccharides
Direct thrombin inhibitors
Vitamin K antagonists
Management of bleeding complications
Unfractionated heparin and low-molecular weight heparins
Pentasaccharides
Direct thrombin inhibitors
Vitamin K antagonists

   Special situations
 
Vitamin K antagonists in pregnant patients with artificial heart valves
Renal failure and haemodialysis
Surgery, percutaneous coronary interventions, biopsies, and dental procedures
Cancer

   Anticoagulant therapy in combination with other drugs interfering with haemostasis
 
Anticoagulant therapy in combination with antiplatelet therapy
Anticoagulant therapy in combination with fibrinolytic therapy

   Current needs and future developments
 

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