Abstract
Balancing safety and efficacy of anticoagulation strategies is a fundamental goal in the performance of percutaneous coronary interventions. The ideal anticoagulant in the catheterization laboratory should effectively prevent thrombosis, yield a low bleeding risk, be titratable to individual clinical needs, be reversible when clinically indicated and be administered without the need for complicated infusions or routine monitoring. Despite its many drawbacks, unfractionated heparin continues to be the most commonly used anticoagulant in percutaneous coronary intervention. Nevertheless, anticoagulation options in the catheterization laboratory have grown substantially over the past 20 years and now include direct thrombin inhibitors, low-molecular-weight heparin molecules and Factor X inhibitors. Additional options are anticipated in the near future with novel agents targeting upstream factors in the coagulation cascade. The availability of multiple anticoagulation options allows for a tailored approach based on the individual patients risk of thrombosis and bleeding. However, multiple anticoagulant choices add complexity in the catheterization laboratory because anticoagulants differ in the mode of administration, monitoring and duration of action. We present a review of current anticoagulation options, novel agents in development and practical issues such as monitoring, switching agents and importance of site access choice.
| Original language | English |
|---|---|
| Pages (from-to) | 559-577 |
| Number of pages | 19 |
| Journal | Interventional Cardiology |
| Volume | 2 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2010 |
| Externally published | Yes |
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Keywords
- anticoagulant
- coronary artery disease
- percutaneous coronary intervention
- thrombosis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Anticoagulation in percutaneous coronary intervention. / O'Neill, Brian P.; Shaw, Eric Scot; Cohen, Mauricio G.
In: Interventional Cardiology, Vol. 2, No. 4, 01.08.2010, p. 559-577.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Anticoagulation in percutaneous coronary intervention
AU - O'Neill, Brian P.
AU - Shaw, Eric Scot
AU - Cohen, Mauricio G
PY - 2010/8/1
Y1 - 2010/8/1
N2 - Balancing safety and efficacy of anticoagulation strategies is a fundamental goal in the performance of percutaneous coronary interventions. The ideal anticoagulant in the catheterization laboratory should effectively prevent thrombosis, yield a low bleeding risk, be titratable to individual clinical needs, be reversible when clinically indicated and be administered without the need for complicated infusions or routine monitoring. Despite its many drawbacks, unfractionated heparin continues to be the most commonly used anticoagulant in percutaneous coronary intervention. Nevertheless, anticoagulation options in the catheterization laboratory have grown substantially over the past 20 years and now include direct thrombin inhibitors, low-molecular-weight heparin molecules and Factor X inhibitors. Additional options are anticipated in the near future with novel agents targeting upstream factors in the coagulation cascade. The availability of multiple anticoagulation options allows for a tailored approach based on the individual patients risk of thrombosis and bleeding. However, multiple anticoagulant choices add complexity in the catheterization laboratory because anticoagulants differ in the mode of administration, monitoring and duration of action. We present a review of current anticoagulation options, novel agents in development and practical issues such as monitoring, switching agents and importance of site access choice.
AB - Balancing safety and efficacy of anticoagulation strategies is a fundamental goal in the performance of percutaneous coronary interventions. The ideal anticoagulant in the catheterization laboratory should effectively prevent thrombosis, yield a low bleeding risk, be titratable to individual clinical needs, be reversible when clinically indicated and be administered without the need for complicated infusions or routine monitoring. Despite its many drawbacks, unfractionated heparin continues to be the most commonly used anticoagulant in percutaneous coronary intervention. Nevertheless, anticoagulation options in the catheterization laboratory have grown substantially over the past 20 years and now include direct thrombin inhibitors, low-molecular-weight heparin molecules and Factor X inhibitors. Additional options are anticipated in the near future with novel agents targeting upstream factors in the coagulation cascade. The availability of multiple anticoagulation options allows for a tailored approach based on the individual patients risk of thrombosis and bleeding. However, multiple anticoagulant choices add complexity in the catheterization laboratory because anticoagulants differ in the mode of administration, monitoring and duration of action. We present a review of current anticoagulation options, novel agents in development and practical issues such as monitoring, switching agents and importance of site access choice.
KW - anticoagulant
KW - coronary artery disease
KW - percutaneous coronary intervention
KW - thrombosis
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UR - http://www.scopus.com/inward/citedby.url?scp=77956149373&partnerID=8YFLogxK
U2 - 10.2217/ica.10.46
DO - 10.2217/ica.10.46
M3 - Article
AN - SCOPUS:77956149373
VL - 2
SP - 559
EP - 577
JO - Interventional Cardiology
JF - Interventional Cardiology
SN - 1755-5302
IS - 4
ER -