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2011, Number 4

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Rev Med Inst Mex Seguro Soc 2011; 49 (4)

The new oral anticoagulants in surgery

García-Chávez J

Language: Spanish
References: 52
Page: 393-399
PDF size: 48.72 Kb.


ABSTRACT

We can stimated the probability to develop thromboembolic disease and consequently prescribe antithrombotic measures to patients undergoing surgery. The anticoagulants carries the risk of abnormal bleeding which can sometimes be fatal. Recently, this concept changes with the development of new drugs that retain their antithrombotic activity but decrease its anticoagulant effect; other advantages are: route of administration, predictable bioavailability (generally do not require monitoring), little interaction with food and other drugs. The most representative are direct factor Xa inhibitors like apixaban and rivaroxabán as well as factor IIa inhibitors such as dabigatran. They had been evaluated in patients undergoing hip or knee surgery in comparison with low molecular weight heparins, in general they had better results in efficacy and similar in safety. Trials are now underway to evaluate its use in other surgical and non surgical environments. Today, the surgical patient is older and had comorbidities such as atrial fibrillation, prosthetic valves, diabetes mellitus, hypertension and others chronic diseases. These patients need be protect from thrombosis with low bleeding risk. New antithrombotic drugs offer a margin of safety, maintaining efficacy; therefore constitute advantageous to classical anticoagulant drugs. We highlight concepts related with the need for thromboprophylaxis and the new antithrombotic medication in a surgical context.


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