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Einsatz von neuen Antikoagulanzien bei kardiovaskulären Erkrankungen

Use of new anticoagulants for cardiovascular diseases

  • CME Weiterbildung · Zertifizierte Fortbildung
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Der Kardiologe Aims and scope

Zusammenfassung

Neben einer Steigerung der Effektivität gilt eine gleichzeitige Senkung des Blutungsrisikos als Voraussetzung für neue Antikoagulanzien im Bereich der kardiovaskulären Medizin. Durch eben diese Eigenschaften schafften es der anti-Xa-Inhibitor Fondaparinux und das direkte Antithrombin Bivalirudin, in die internationalen Leitlinien zur Behandlung des akuten Koronarsyndroms aufgenommen zu werden, und haben hier einen bedeutsamen Stellenwert neben den Heparinen erlangt. Andere Substanzen stehen kurz vor der Einführung in die klinische Routine, wie etwa das oral verfügbare Antithrombin Dabigatran für Patienten mit Vorhofflimmern. Anti-Xa-Inhibitoren wie Rivaroxaban und Apixapan werden in der Indikation des akuten Koronarsyndroms wie auch bei Vorhofflimmern geprüft. Die vorliegende Arbeit versucht die aktuellen Erkenntnisse zu den neuen Antikoagulanzien dem Leser übersichtlich vorzustellen.

Abstract

Apart from higher efficacy a lower risk of bleeding has become the main target for the development of new anticoagulants in cardiovascular medicine. Due to these characteristics the anti-Xa inhibitor fondaparinux as well as the direct antithrombin bivalirudin have been included in the updated international guidelines for the therapy of patients with acute coronary syndromes. Other anti-Xa inhibitors, e.g. apixapan and rivaroxaban, are still in the field of investigation. Moreover, the new direct antithrombin dabigatran will be used for anticoagulation in atrial fibrillation and has become the primary alternative medication to vitamin K antagonists. This review tries to introduce the most important new anticoagulants by presenting current study results.

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Authors and Affiliations

  1. 3. Medizinische Abteilung mit Kardiologie und Internistischer Notaufnahme, Wilhelminenspital, Montleartstr. 37, 1160, Wien, Österreich

    T. Höchtl, S. Farhan & K. Huber M.D., FACC, FESC

  2. 2. Universitätsklinik für Innere Medizin mit Kardiologie und Angiologie, Medizinische Universität Wien, Wien, Österreich

    J. Wojta

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  1. T. Höchtl
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  2. S. Farhan
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  3. J. Wojta
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  4. K. Huber M.D., FACC, FESC
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Correspondence to K. Huber M.D., FACC, FESC.

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Höchtl, T., Farhan, S., Wojta, J. et al. Einsatz von neuen Antikoagulanzien bei kardiovaskulären Erkrankungen. Kardiologe 5, 129–144 (2011). https://doi.org/10.1007/s12181-010-0306-y

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