New developments in the treatment of deep venous thrombosis

Abstract

An initial course of standard heparin (SH) or low-molecular-weight heparins (LMWH) is regarded as the treatment of choice for patients with deep venous thrombosis (DVT). LMWH have better bioavailability after subcutaneous administra tion, have a longer half-life, and show higher and more predictable anticoagulant activity. As a result they can be given subcutaneously and without laboratory control, using a dose that is determined by body weight. Because of these multiple advantages of LMWH they will replace SH in the future and subsequently home treatment with LMWH of selected patients seems feasible. The currently accepted approach is to start with SH or LMWH therapy combined with oral anticoagulant therapy (OAT) at the time of diagnosis. The course of SH or LMWH should continue for at least 5 days, provided that international normalized ratio (INR) is in the therapeutic range on 2 consecutive days. OAT should be continued for at least 3 months to prolong the prothrombin time to an INR of 2 -3 . When oral anticoagulants are either contraindicated or inconvenient, SH or LMWH can be used at the middosing interval. The role of anti-platelet treatment is not yet established 4 and should be compared with coumarin therapy in the future.

Impacto clínico y metabólico de los anticonceptivos hormonales combinados según vía de administración y gestágeno utilizado

“…En la mayoría de las variables procoagulativas no se registraron diferencias entre el anillo y el AOC 30 EE/150 LNG; no obstante, en comparación con el valor basal de la concentración del factor VII, se puso de manifiesto un incrementó en el grupo del ENG y se redujo en el grupo del AOC 30 EE/150 LNG. Estos cambios, tienen una relevancia clínica limitada con vistas a la enfermedad venosa, dado que se ha demostrado, que el factor VII no guarda relación con el riesgo de tromboembolismo venoso (89,102).…”