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What is anti-clotting medication and how is it used safely?

Anti-clotting medication is used to prevent blood clots from forming, and therefore lower the risk of certain cardiovascular diseases like heart attacks and strokes. As the name suggests, they make sure that the blood does not clot as quickly.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 26, 2014

Direct thrombin inhibitors compared with vitamin K antagonists in people with atrial fibrillation for preventing stroke

Question: We wanted to compare the effectiveness and safety of direct thrombin inhibitors (DTIs) with vitamin K antagonists in people with atrial fibrillation (AF) to prevent stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

New types of anticoagulants to prevent deep vein thrombosis and pulmonary embolism following total hip or knee replacement surgery

Venous thromboembolism is the presence of a blood clot that blocks a blood vessel within the venous system; it includes deep vein thrombosis (DVT) and pulmonary embolism (PE) which can be fatal. Venous thromboembolism occurs in 44% to 90% of those patients who undergo total hip or knee replacement and who do not receive anticoagulants (blood thinning drugs).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antiplatelet agents and anticoagulants for hypertension

Daily aspirin reduces the incidence of heart attacks to a small degree, but increases the incidence of major bleeding events to a similar degree in patients treated for high blood pressure who have not had a prior stroke or heart attack. In patients with high blood pressure who have had a stroke or heart attack, the benefits of daily low‐dose aspirin outweigh the harms. There is no evidence of benefit for antithrombotic therapy with warfarin alone or in combination with aspirin in patients with high blood pressure. The benefits and harms of the newer drugs glycoprotein IIb/IIIa inhibitors, clopidogrel, prasugrel, ticagrelor and oral antithrombotic agents such as dabigatran and rivaroxaban for patients with high blood pressure have not been studied in clinical trials.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Blood thinners for pulmonary hypertension

The heart has four chambers: two upper and two lower chambers. The lower right chamber, also known as the right ventricle, pumps blood through the pulmonary artery to the lungs, where the blood receives oxygen. Pulmonary hypertension occurs when pressure in the pulmonary arteries is increased to above normal (8 to 25 mmHg). When this happens over time, inflammation of the pulmonary artery occurs. The arteries may then become stiff and tighten. These changes make it difficult for the heart to pump blood to the lungs. The heart becomes weaker as it tries to push against this pressure; the resulting disturbance to blood flow can lead to blood clots. These clots can travel to the lungs, which can worsen the person's condition and may result in death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Blood thinners for the long‐term treatment of blood clots in patients with cancer

Patients with cancer are at an increased risk of developing blood clots and might respond differently to blood thinners (anticoagulants) compared with patients without cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Novel oral anticoagulants for the treatment of deep vein thrombosis

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep vein of the leg or pelvis. It affects approximately 1 in 1000 people. If it is not treated, the clot can travel in the blood and block the arteries in the lungs. This life‐threatening condition is called a pulmonary embolism (PE) and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a DVT can be increased if people have certain risk factors. These include previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), trauma and blood disorders such as thrombophilia (abnormal blood clotting). A DVT is diagnosed through determining the risk factors and performing an ultrasound of the leg veins. If a DVT is confirmed, people are treated with an anticoagulant. This medicine prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Two further classes of novel oral anticoagulants have been developed: these are called direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might now be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re‐dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs with conventional treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Novel oral anticoagulants (DOACs) for the treatment of pulmonary embolism

Venous thromboembolism is a condition where a blood clot forms in the deep veins (DVT) (most commonly of the leg) and can travel up to block the arteries in the lungs (pulmonary embolism). Pulmonary embolism is life‐threatening and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a pulmonary embolism can increase with risk factors, including previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), blood disorders (thrombophilia) and trauma. A pulmonary embolism is diagnosed by determining the risk factors and scanning the lungs to check for a clot. If a pulmonary embolism is confirmed, patients are treated with an anticoagulant. This prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Recently two classes of direct oral anticoagulants (DOACs) have been developed: direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re‐dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs compared with conventional treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

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