Anticoagulation in the Management of Acute Pulmonary Embolism-A Review.

IF 0.5 Q4 PERIPHERAL VASCULAR DISEASE
International Journal of Angiology Pub Date : 2024-03-12 eCollection Date: 2024-06-01 DOI:10.1055/s-0044-1782537
Raul Del Toro Mijares, Adrian Rojas Murguia, Mateo Porres-Aguilar, Debabrata Mukherjee
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引用次数: 0

Abstract

Venous thromboembolism (VTE) is a very frequent cardiovascular entity that encompasses deep vein thrombosis and pulmonary embolism (PE). This last entity represents a major cause of cardiovascular morbidity and mortality. The incidence of PE and the rate of PE-related morbidity significantly increase with age, race, and underlying medical conditions, such as malignancy. Given the recent advances in diagnostic strategies and algorithms, patients can be risk assessed and treated promptly to avoid disease progression. Anticoagulation is the mainstay of treatment for acute PE that is not hemodynamically unstable. Direct oral anticoagulants, such as apixaban, rivaroxaban, or edoxaban, are currently the preferred agents for the treatment of patients who present with acute PE or for long-term treatment. Treatment duration should be continued for at least 3 months, and all patients should be assessed for extended duration of therapy based on the precipitating factors that led to the development of the VTE. Novel anticoagulant agents targeting factor XI/XIa are currently being investigated in phases 2 and 3 clinical trials, representing an attractive option in anticoagulation therapies in patients with VTE. For hemodynamically unstable patients, systemic thrombolysis is the treatment of choice, and it may also be of benefit-in reduced dose-for patients with intermediate to high risk who are at risk of hemodynamic collapse.

急性肺栓塞治疗中的抗凝疗法--综述。
静脉血栓栓塞症(VTE)是一种非常常见的心血管疾病,包括深静脉血栓形成和肺栓塞(PE)。静脉血栓栓塞症是心血管疾病发病和死亡的主要原因。肺栓塞的发病率和与肺栓塞相关的发病率随年龄、种族和恶性肿瘤等基础疾病而显著增加。鉴于诊断策略和算法的最新进展,可以对患者进行风险评估并及时治疗,以避免病情恶化。抗凝是治疗血流动力学不稳定的急性 PE 的主要方法。阿哌沙班、利伐沙班或埃多沙班等直接口服抗凝剂是目前治疗急性 PE 患者或长期治疗的首选药物。治疗时间至少应持续 3 个月,所有患者都应根据导致 VTE 发生的诱发因素评估是否需要延长治疗时间。目前,针对因子 XI/XIa 的新型抗凝剂正在进行 2 期和 3 期临床试验研究,这将成为 VTE 患者抗凝疗法中极具吸引力的选择。对于血流动力学不稳定的患者,全身溶栓是首选治疗方法,对于有血流动力学衰竭风险的中高危患者,减量溶栓也可能有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Angiology
International Journal of Angiology PERIPHERAL VASCULAR DISEASE-
CiteScore
1.30
自引率
16.70%
发文量
57
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