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Am J Surg. 2014 Jan;207(1):95-101. doi: 10.1016/j.amjsurg.2013.04.004. Epub 2013 Oct 15.

Antiplatelet and anticoagulation medications and the surgical patient.

Author information

  • 1Department of Surgery, Temple University Hospital, 3401 North Broad Street, Suite 450, Philadelphia, PA 19140, USA. Electronic address:
  • 2Department of Pharmacy, Temple University Hospital, Philadelphia, PA, USA.
  • 3Division of Surgical Critical Care and Trauma, Temple University Hospital, 3401 North Broad Street, Suite 450, Philadelphia, PA 19140, USA.



Acute coronary syndrome affects more than 750,000 Americans per year, and antiplatelet agents are the cornerstones of treatment. Atrial fibrillation affects 2.4 million patients in the United States, and venous thromboembolism occurs in 1 to 2 per 1,000 adults per year. Anticoagulants are commonly prescribed to affected patients. Surgeons are commonly called upon to care for patients taking medications that affect normal coagulation. It is important that the surgical community has a fundamental understanding of these agents' pharmacology, which may impact patients' clinical course.


A review of recent literature on pharmacologic agents that affect coagulation was performed.


A number of medications that alter normal coagulation were reviewed in this article including their pharmacologic properties and reversal strategies.


There are a variety of medications that affect a patient's coagulation ability, including many newer agents on the market. This review provides surgeons with the knowledge needed to assist in caring for individuals receiving these drugs.


Anticoagulation; Antiplatelet; Bleeding; Novel oral anticoagulants; Thrombosis

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