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

  • Paolo GreseleEmail author
  • Chiara Busti
  • Gloria Paganelli
Chapter
Part of the Handbook of Experimental Pharmacology book series (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.

Keywords

Acute Coronary Syndrome (ACS) Fondaparinux Heparin induced thrombocytopenia (HIT) Low-Molecular-Weight heparin (LMWH) Pulmonary Embolism (PE) Superficial Vein Thrombosis (VVT) Unfractionated Heparin (UFH) Venous Thromboembolism (VTE) 

Notes

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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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Internal and Cardiovascular Medicine, Department of Internal MedicineUniversity of PerugiaPerugiaItaly

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