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Cirugía y los nuevos anticoagulantes orales
Resumen
Actualmente en los pacientes sometidos a cirugía u hospitalizados con afecciones médicas podemos medir la probabilidad para desarrollar enfermedad tromboembólica venosa, y en función de tal probabilidad indicar manejo tromboprofiláctico con anticoagulantes o medidas antitrombóticas no medicamentosas. El uso de anticoagulantes siempre conlleva el riesgo de provocar un sangrado anormal potencialmente faltal. Últimamente este concepto ha sufrido cambios favorables tanto para el paciente como para los médicos, concretamente en el desarrollo de nuevos medicamentos que conservan su actividad antitrombótica, pero disminuyen considerablementesu efecto anticoagulante y con esto el riesgo de hemorragia, además de otras ventajas como la vía de administración, la biodisponibilidad predecible y la poca interacción con alimentos y otras medicinas. Así, hacemos referencia a los inhibidores directos del factor Xa de la coagulación como el rivaroxabán y el apixabán, y también a los inhibidores del factor IIa como el dabigatrán, agentes evaluados en el posoperatorio de los pacientes sometidos a cirugía de reemplazo total de cadera o rodilla con resultados mejores en términos de eficacia, y similares en términos de seguridad a las heparinas de bajo peso molecular. Actualmente están en curso los ensayos para evaluar su uso en otros entornos quirúrgicos y en pacientes no quirúrgicos.
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Sere KM, Hackeng TM. Mecanismos básicos de hemostasia. Semin Vasc Med 2003; 3 (1): 3-12.
Laposata M, Green D, Van Cott EM, Barrowcliffe TW, Goodnight SH, Sosolik RC. College of American Pathologists Conference XXXI sobre el control de laboratorio de la terapia anticoagulante: el uso clínico y el control de laboratorio de heparina de bajo peso molecular, danaparoid, hirudina y compuestos relacionados, y argatroban. Arch Pathol Lab Med 1998; 122 (9): 799 - 807.
Collins R, Scrimgeour A, Yusuf S, Peto R. Reducción de embolia pulmonar fatal y trombosis venosa mediante administración perioperatoria de heparina subcutánea. Descripción general de los resultados de los ensayos aleatorios en cirugía general, ortopédica y urológica. N Engl J Med 1988; 318 (18): 1162-1173.
Kearon C. Historia natural de tromboembolismo venoso. Circulation 2003; 107 (23 Suppl 1): 122-130.
Ollendorf DA, Vera-Llonch M, Oster G. Cost of venous thromboembolism following major orthopedic surgery in hospitalized patients. Am J Health Syst Pharm 2002; 59(18):1750-1754.
Oster G, Ollendorf DA, Vera-Llonch M, Hagiwara M, Berger A, Edelsberg J. Economic consequences of venousthromboembolism following major orthopedic surgery. Ann Pharmacother 2004;38(3):377-382. Epub 2004 Jan 12.
Spyropoulos AC, Lin J. Direct medical costs of venous thromboembolism and subsequent hospital readmissionrates: An administrative claims analysis from 30 managed care organizations. J Manag Care Pharm 2007; 13(6):475-486.
Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, et al. ENDORSE Investigators. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): A multinational cross-sectional study. Lancet 2008;371(9610): 387-394. Erratum in Lancet 2008;371(9628): 1914.
Mammen EF. Pathogenesis of venous thrombosis. Chest 1992;102(Suppl):640S-644S.
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd. Risk factors for deep vein thrombosis and pulmonary embolism: A population based case-control study. Arch Intern Med 2000;160(6)809-815.
Rahman M, Beattie J. Surgery and venous thromboembolism. Pharm J 2004;273:687-689.
Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW, American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133(3 Suppl):381S-453S.
Cardiovascular Disease Educational and Research Trust, Cyprus Cardiovascular Disease Educational and Research Trust, European Venous Forum, International Surgical Thrombosis Forum, International Union of Angiology, Union Internationale de Phlebologie. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol 2006;25(2):101-161.
Guyatt GH, Cook DJ, Jaeschke R, Pauker SG, Schunemann HJ. Grades of recommendation for antithrombotic agents: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th edition). Chest 2008;133(6 Suppl):123S-131S.
White RH, Zhou H, Romano PS. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures. Thromb Haemost 2003;908(3):446-455.
Friedman RJ, Gallus AS, Cushner FD, Fitzgerald G, Anderson FA Jr; Global Orthopaedic Registry Investigators. Physician compliance 398 Rev Med Inst Mex Seguro Soc 2011; 49 (4): 393-399 García-Chávez J. Nuevos anticoagulantes orales with guidelines for deepvein thrombosis prevention in total hip and knee arthroplasty. Curr Med Res Opin 2008;24(1)87-97.
White RH, Romano PS, Zhou H, Rodrigo J, Bargar W. Incidence and time course of thromboembolic outcomes following total hip or knee arthroplasty. Arch Intern Med 1998;158(1|4):1525-1531.
Ziomek S, Read RC, Tobler HG, Harrell JE Jr, Gocio JC, Fink LM, et al. Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 1993;56(2):223-226. [Discussion 227].
Kalweit G, Huwer H, Volkmer I, Petzold T, Gams E. Pulmonary embolism: a frequent cause of acute fatality after lung resection. Eur J Cardiothorac Surg 1996;10:(4)242- 246. [Discussion 246-247].
Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg 2005;130(2): 438-444.
Josa M, Siouffi SY, Silverman AB, Barsamian EM, Khuri SF, Sharma GV. Pulmonary embolism after cardiac surgery. J Am Coll Cardiol 1993;21(4):990-996.
Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001;135(12):1061- 1073.
Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg 2003;76 (2):2121–2131.
Smythe MA, Koerber JM, Mattson JC. The incidence of recognized heparin-induced thrombocytopenia in a large, tertiary care teaching hospital. Chest 2007;131(6):1644- 1649.
Singer DE, Albers GW, Dalen JE, Fang MC, Go AS, Halperin JL, et al. American College of Chest Physicians. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133(6 Suppl):546S592S.
Warkentin TE, Greinacher A, Koster A, Lincoff AM; American College of Chest Physicians. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008;133(6 Suppl): 340S-380S.
Hoffman M, Monroe DM 3rd. A cell-based model of hemostasis. Thromb Haemost 2001;85(6):958-965.
Aird WC. Vascular bed-specific thrombosis. J Thromb Haemost 2007; 5(Suppl 1):283-291.
Roberts HR, Monroe DM, Escobar MA. Current concepts of hemostasis: Implications for therapy. Anesthesiology 2004;100(3):722-730.
Hirsh J, Bauer KA, Donati MB, Gould M, Samama MM, Weitz JI; American College of Chest Physicians. Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133(6 Suppl):141S-159S.
Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti GM; American College of Chest Physicians. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based. Clinical Practice Guidelines (8th Edition). Chest 2008;133(6 Suppl):160S198S.
Levy JH, Tanaka KA, Dietrich W. Perioperative hemostatic management of patients treated with vitamin K antagonists. Anesthesiology 2008;109(5):918-926.
Ansell J. Factor Xa or thrombin: Is factor Xa a better target? J Thromb Haemost 2007;5(Suppl 1):60-64.
Weitz JI. Factor Xa or thrombin: Is thrombin a better target? J Thromb Haemost 2007;5(Suppl 1):65-67.
Perzborn E, Strassburger J, Wilmen A, Pohlmann J, Roehrig S, Schlemmer KH, et al. In vitro and in vivo studies of the novel antithrombotic agent BAY59 –7939 –an oral, direct Factor Xa inhibitor. J Thromb Haemost 2005; 3(3):514-521.
Kubitza D, Becka M, Voith B, Zuehlsdorf M, Wensing G. Safety, pharmacodynamics, and pharmacokinetics of single doses of BAY 59–7939, an oral, direct factor Xa inhibitor. Clin Pharmacol Ther 2005;78(4):412–421.
Eriksson BI, Quinlan DJ, Weitz JI. Comparative pharmacodynamics and pharmacokinetics of oral direct thrombin and factor Xa inhibitors in development. Clin Pharmacokinet 2009;48(1):1-22.
Eriksson BI, Borris LC, Friedman RJ, Haas S, Huisman MV, Kakkar AK, et al. RECORD1 Study Group. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med 2008;358(26):2765-75.
Kakkar AK, Brenner B, Dahl OE, Eriksson BI, Mouret P, Muntz J, et al. RECORD2 Investigators. Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial. Lancet 2008;372(9632):31-39.
Lassen MR, Ageno W, Borris LC, Lieberman JR, Rosencher N, Bandel TJ, et al. RECORD3 Investigators. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med 2008;358(26):2776-2786.
Turpie AGG, Lassen MR, Davidson BL, Bauer KA, Gent M, Kwong LM, et al. RECORD4 Investigators. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): A randomised trial. Lancet 2009;373(9676):1673-1680.
Turpie AG, Lassen MR, Kakkar A, Eriksson BI, Misselwitz F, Bandel TJ, et al. A pooled analysis of four pivotal studies of rivaroxaban for the prevention of venous thromboembolism after orthopaedic surgery: Effect on symptomatic venous thromboembolism death, and bleeding (abstract). Blood 2008;112:abstract 36. Rev Med Inst Mex Seguro Soc 2011; 49 (4): 393-399 399 García-Chávez J. Nuevos anticoagulantes orales.
Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Engl J Med 2009;361 (6):594-604.
Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Hornick P, ADVANCE-2 investigators. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE2): A randomised double-blind trial. Lancet 2010;375(9717): 807-815. Epub 2009 May 26.
APPRAISE Steering Committee and Investigators, Alexander JH, Becker RC, Bhatt DL, Cools F, Crea F, Dellborg M, et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: Results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009;119(22):2877-2885. Epub 2009 May 26.
Turpie AG, Bauer KA, Davidson BL, Fisher WD, Gent M, Huo MH, et al. EXPERT Study Group. A randomized evaluation of betrixaban, an oral factor Xa inhibitor, for prevention of thromboembolic events after total knee replacement (EXPERT). Thromb Haemost 2009;101(1): 68-76.
Cohen AT, Armstrong D, Gazdzik T, Ryge C, Pak R, Mandema J, y col. Estudio de ajuste de dosis de diseño adaptativo de PD 0348292, nuevo inhibidor oral del Factor Xa, para la tromboprofilaxis después de la cirugía de reemplazo total de rodilla. Blood 2008; 112: Resumen 980
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