Zusammenfassung
Durch ihre gerinnungshemmende Wirkung sind Antikoagulanzien potente Antithrombotika, die sehr erfolgreich zur Prophylaxe und Therapie von thromboembolischen Erkrankungen eingesetzt werden. Durch eine konsequent umgesetzte medikamentöse Thromboseprophylaxe konnte das Thromboserisiko und damit die Rate an Lungenembolien selbst bei Hochrisikoeingriffen, wie großen orthopädischen Operationen, signifikant gesenkt werden. Auch in der Therapie und anschließenden Rezidivprophylaxe von venösen Thrombosen stellt die Gabe von Antikoagulanzien den zentralen Therapieansatz dar. Gleiches gilt für die Prophylaxe von kardiogenen Thromboembolien bei Patienten mit kardialen Arrhythmien. Während bis vor wenigen Jahren die Heparine und die Vitamin-K-Antagonisten die dominierenden Antikoagulanzien waren, steht inzwischen eine breite Palette von Antikoagulanzien mit verbesserten pharmakologischen Profilen zur Verfügung. Inwieweit sich durch sie Effizienz, Sicherheit und Akzeptanz von antikoagulatorischen Therapien verbessern lassen, ist noch nicht abschließend beurteilbar.
Abstract
Anticoagulant drugs belong to the group of antithrombotic agents and are successfully used in the prophylaxis and treatment of thromboembolic disorders. The use of anticoagulants in the prevention of deep venous thrombosis has significantly lowered the risk of venous thrombosis and fatal pulmonary embolisms even in high-risk situations such as orthopedic surgery. Anticoagulants play a central role in the treatment of acute venous thrombosis and in the prevention of recurrent events. Long-term anticoagulation therapy with orally active anticoagulants significantly reduces the risk of thromboembolic complications in patients showing cardiac arrhythmias. Whereas a few years ago heparins and vitamin K antagonists were the dominant anticoagulants, today a wide range of anticoagulants with improved pharmacological profiles are available. It remains an open question whether these new anticoagulants will improve the efficacy, safety, and acceptance of anticoagulant treatment approaches.
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Der korrespondierende Autor weist auf folgende Beziehung/en hin: Der Autor hat Vortragshonorare von folgenden Firmen erhalten: Boehringer Ingelheim, CSL Behring, Roche Diagnostics.
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Pötzsch, B. Antikoagulation. Med Klin Intensivmed Notfmed 108, 325–336 (2013). https://doi.org/10.1007/s00063-013-0243-1
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DOI: https://doi.org/10.1007/s00063-013-0243-1