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Heparin - A Century of Progress pp 179–209Cite as

Heparin in the Prophylaxis and Treatment of Venous Thromboembolism and Other Thrombotic Diseases

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 207))

Abstract

In this chapter, we discuss the key-role of heparin in the prophylaxis and treatment of venous thromboembolism (VTE) and other thrombotic disorders. Heparin exerts its antithrombotic effects by facilitating the ability of antithrombin (AT), a plasma serum protease inhibitor, to inhibit thrombin (factor IIa) and factor Xa. Different heparin formulations can be used for the prophylaxis of thrombosis and treatment, going from unfractionated heparin (UFH), different low-molecular-weight heparin (LMWH) preparations, to the recently introduced synthetic pentasaccharide fondaparinux. All heparin formulations can be administrated only by the parenteral route, including the intravenous (iv) and the subcutaneous (sc) route. We will overview the clinical evidence for the use of different heparin formulations in the prophylaxis and treatment of venous thromboembolism, of superficial vein thrombosis and of acute coronary syndromes (ACS). Special issues, like the use of heparins in pregnancy or in children, will also be discussed. Although heparin is an almost one century-old drug it remains a cornerstone of antithrombotic treatment.

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Acknowledgment

The skilful help of Dr. Sara Orsini with editorial handling is gratefully acknowledged. This study was supported by grants from Fondazione Cassa di Risparmio di Perugia (project n. 2009-020-0097), MIUR (2007, Prot. 20073KBBHC_003 ) and the Italian Ministry of Health (RFPS-2006-8-334062) to P. G.

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Authors and Affiliations

  1. Division of Internal and Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Via E. dal Pozzo, 06126, Perugia, Italy

    Paolo Gresele, Chiara Busti & Gloria Paganelli

Authors
  1. Paolo Gresele
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  2. Chiara Busti
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  3. Gloria Paganelli
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Corresponding author

Correspondence to Paolo Gresele .

Editor information

Editors and Affiliations

  1. School of Pharmacy, University of London, Brunswick Square 29-39, London, WC1N 1AX, United Kingdom

    Rebecca Lever

  2. Standards and Control, National Institute for Biological, Blanche Lane, Potters Bar, Herts., EN6 3QG, United Kingdom

    Barbara Mulloy

  3. King's College London, Sackler Inst. Pulmonary Pharmacology, Waterloo Campus, London, SE1 9NH, United Kingdom

    Clive P. Page

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Gresele, P., Busti, C., Paganelli, G. (2012). Heparin in the Prophylaxis and Treatment of Venous Thromboembolism and Other Thrombotic Diseases. In: Lever, R., Mulloy, B., Page, C. (eds) Heparin - A Century of Progress. Handbook of Experimental Pharmacology, vol 207. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23056-1_9

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