Abstract
Anticoagulation therapy is utilized for many thromboembolic indications with oral therapy being the first-line therapy choice for long-term management of many of these disorders. Warfarin has been utilized for decades as the primary oral anticoagulant, and more recently, oral direct thrombin inhibitors and factor Xa inhibitors have emerged as alternative therapies. Subcutaneous and intravenous therapies are also often utilized in clinical practice most commonly as short-term therapies for bridging or the ability to initiate long-term anticoagulation. Dentists should be familiar with these agents and also be aware of potential drug interactions that may increase or decrease anticoagulant serum concentrations and alter clinical efficacy. Concomitant use with antiplatelet agents and the perioperative management of these agents, including the need for anticoagulation reversal, are discussed in other chapters of this book.
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Cove CL, Hylek EM. An updated review of target specific oral anticoagulants used in stroke prevention in atrial fibrillation, venous thromboembolic disease, and acute coronary syndrome. J Am Heart Assoc. 2013;2:e000136. https://doi.org/10.1161/JAHA.113.000136.
DeWilde S, Carey IM, Emmas C, Richards N, Cook DG. Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care. Heart. 2006;92:1064–70. https://doi.org/10.1136/hrt.2005.069492.
Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864–70. https://doi.org/10.1001/jama.285.22.2864.
Hirsh J, Guyatt G, Albers GW, Harrington R, Schunemann HJ. Antithrombotic and thrombolytic therapy: American College of Chest Physicians evidence based clinical practice guidelines. Chest. 2008;133:110S–2S. https://doi.org/10.1378/chest.08-0652.
Alikhan R, Peters F, Wilmott R, Cohen AT. Fatal pulmonary embolism in hospitalised patients: a necropsy review. J Clin Pathol. 2004;57:1254–7. https://doi.org/10.1136/jcp.2003.013581.
Schaefer JK, McBane RD, Wysokinski WE. How to choose appropriate direct oral anticoagulant for patient with nonvalvular atrial fibrillation. Ann Hematol. 2016;95:437–49. https://doi.org/10.1007/s00277-015-2566-x.
Geerts WH, Bergqist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al. Prevention of thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133(6):381S–453S. https://doi.org/10.1378/chest.08-0656.
Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, et al. Antithrombotic therapy for VTE disease. Antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians evidence-based practice guidelines. Chest. 2012;141(2 Suppl):e419–94S. https://doi.org/10.1378/chest.11-2301.
Ansell JE. Oral anticoagulant therapy-50 years later. Arch Intern Med. 1993;153:586–96. https://doi.org/10.1001/archinte.1993.00410050024005.
Bristol-Myers Squibb. Coumadin (warfarin) prescribing information. 2016. http://packageinserts.bms.com/pi/pi_coumadin.pdf. Accessed 23 Dec 2016.
Hirsh J, Dalen JE, Anderson DR, Poller L, Bussey H, Ansell J, et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 2001;119:8S–21S. https://doi.org/10.1378/chest.119.1_suppl.8S.
Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: chest guideline and expert panel report. Chest. 2016;149(2):315–52. https://doi.org/10.1016/j.chest.2015.11.026.
Witt DM, Clark NP. Venous thromboembolism. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: a pathophysiologic approach. 9th ed. New York, NY: McGraw-Hill; 2014. p. 245–78.
Holbrook AM, Pereira JA, Labris R, McDonald H, Douketis JD, Crowther M, et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165:1095–106. https://doi.org/10.1001/archinte.165.10.1095.
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51. https://doi.org/10.1056/NEJMoa0905561.
Schulman S, Kearon C, Kakkar AK, Schellong S, Eriksson H, Baanstra D, et al. Extended use of dabigatran, warfarin, or placebo in venous thromboembolism. N Engl J Med. 2013;368:709–18. https://doi.org/10.1056/NEJMoa1113697.
Boehringer-Ingelheim. Pradaxa (dabigatran) prescribing information. 2017. http://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Pradaxa/Pradaxa.pdf. Accessed 18 Jan 2017.
Samama MM, Guinet C. Laboratory assessment of new anticoagulants. Clin Chem Lab Med. 2011;49(5):761–72. https://doi.org/10.1515/CCLM.2011.134.
Conway SE, Hwang AY, Ponte CD, Gums JG. Laboratory and clinical monitoring of director acting oral anticoagulants: what clinicians need to know. Pharmacotherapy. 2017;37(2):236–48.
Eikelboom JW, Connolly SJ, Brueckmann M, Granger CB, Kappetein AP, Mack MJ, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369:1206–14. https://doi.org/10.1056/NEJMoa1300615.
Liesenfel KH, Staab A, Hartter S, Fromella S, Clemens A, Lehr T. Pharmacometric characterization of dabigatran hemodialysis. Clin Pharmacokinet. 2013;52:453–62. https://doi.org/10.1007/s40262-013-0049-6.
Janssen Pharmaceuticals. Xarelto (rivaroxaban) prescribing information. 2017. http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/202439s001lbl.pdf. Accessed 18 Jan 2017.
Investigators EINSTEIN, Bauersachs R, Berkowitz SD, Brenner B, Buller HR, Decousus H, Gallus AS, et al. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010;363:2499–510. https://doi.org/10.1056/NEJMoa1007903.
Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91. https://doi.org/10.1056/NEJMoa1009638.
Bristol-Myers Squibb Company and Pfizer Inc. Eliquis (apixaban) prescribing information. 2017. http://packageinserts.bms.com/pi/pi_eliquis.pdf. Accessed 18 Jan 2017.
Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92. https://doi.org/10.1056/NEJMoa1107039.
Agnelli G, Buller HR, Cohen A, Curto M, Gallus AS, Johnson M, et al. Apixaban for extended treatment of venous thromboembolism. N Engl J Med. 2013;368:699–708. https://doi.org/10.1056/NEJMoa1207541.
Daiichi Sankyo. Savaysa (edoxaban) prescribing information. 2017. http://dsi.com/prescribing-information-portlet/getPIContent?productName=Savaysa&inline=true. Accessed 19 Jan 2017.
Buller HR, Decousus H, Grosso MA, Mercuri M, Middeldorp S, Prins MH, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369(15):1406. https://doi.org/10.1056/NEJMoa1306638.
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–104. https://doi.org/10.1056/NEJMoa1310907.
Baglin T, Barrowcliffe TW, Cohen A, Greaves M. Guidelines for the use and monitoring of heparin. Br J Haematol. 2006;133(1):19–34. https://doi.org/10.1111/j.1365-2141.2005.05953.x.
GlaxoSmithKline. Arixtra (fondaparinux) prescribing information. 2017. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021345s023lbl.pdf. Accessed 19 Jan 2017.
Spinler SA, Wittowsky AK, Nutescu E, Smythe MA. Anticoagulation monitoring part 2: unfractionated heparin and low-molecular-weight-heparin. Ann Pharmacother. 2005;39:1275–85. https://doi.org/10.1345/aph.1E524.
Greinacher A. Heparin-induced thrombocytopenia. N Engl J Med. 2015;373:252–61. https://doi.org/10.1056/NEJMoa1411910.
Nisio MD, Middeldorp S, Buller HR. Direct thrombin inhibitors. N Engl J Med. 2005;353:1028–40. https://doi.org/10.1056/NEJMoa044440.
Lewis BE, Wallis DE, Berkowitz SD, Matthai WH, Fareed J, Walenga JM, et al. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation. 2001;103:1838–43. https://doi.org/10.1161/01.CIR.103.14.1838.
Lewis BE, Wallis DE, Leya F, Hursting MJ, Kelton JG. Argatroban anticoagulation in patients with heparin-induced thrombocytopenia. Arch Intern Med. 2003;163:1849–56. https://doi.org/10.1001/archinte.163.15.1849.
Hafner G, Roser M, Nauck M. Methods for the monitoring of direct thrombin inhibitors. Semin Thromb Hemost. 2002;28(5):425–30. https://doi.org/10.1055/s-2002-35282.
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Reardon, D.P., Zemaitis, C. (2018). Review of Anticoagulants. In: Szumita, R., Szumita, P. (eds) Hemostasis in Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-319-71240-6_10
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