, Volume 42, Issue 6, pp 753-764
Date: 19 Jan 2013

Antiplatelet medications and evolving antithrombotic medication

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In treatment and prevention of thromboembolic events, the two major classes of anticoagulants are the antiplatelet agents and the antithrombotic agents. The antithrombotic agents have traditionally been heparin and warfarin, both of which were isolated in the 1930s, and have been used effectively since becoming commercially available in treatment and thromboprophylaxis of venous thromboembolic events (VTE). Though effective, they have a narrow therapeutic window and the antithrombotic response is variable, depending on the patient, and requires regular monitoring and adjustment to maintain the necessary therapeutic range. Recently developed novel anticoagulants in the prevention and treatment of VTE are now available and are increasingly encountered in day-to-day practice. A general understanding of these agents is essential in the planning of any interventional procedure in order to optimally balance the risk of hemorrhage, during or after a procedure, with the risk of periprocedural thrombosis.