What You Need to Know about Anticoagulant Therapy

Posted by Brigham and Women's Hospital February 23, 2016

Anterior cut of heart showing normal, healthy heart and conduction system vs. a damaged conduction system with arrows; ACardio_20140401_v2_001.ai SOURCE: cardiacsurg_maze_anat.ai

Anticoagulants are most commonly used to treat patients with atrial fibrillation, a type of irregular heart rhythm.

Anticoagulants (blood thinners) are medications that are used to treat several types of cardiovascular conditions. They are commonly used to treat patients with atrial fibrillation, a type of irregular heart rhythm, and also to help patients with mechanical heart valves or those who have had blood clots in either their veins or arteries.

For many years, warfarin (Coumadin®) was the only anticoagulant treatment option available. In recent years, however, several new types of blood thinners have been shown to be effective and safe, including dabigatran, rivaroxaban, apixaban, and edoxaban. These additional options are significant, as they can be preferable to warfarin in certain cases. The advantages of these newer drugs over warfarin include decreased risk of bleeding, no need for routine laboratory monitoring, and fewer interactions with foods and other drugs. The newer drugs, however, also have some limitations when compared with warfarin. These newer medications, for instance, are short-acting (having effects that last for a short time), which can create problems for patients who have issues with adherence (taking medications as prescribed). It also is easier to reverse the effects of warfarin when patients have a bleeding complication or overdose on their anticoagulant medication.

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Deep Vein Thrombosis: A Silent and Life-Threatening Condition

Posted by Brigham and Women's Hospital February 4, 2014

DVT is a blood clot that develops in a deep vein in the body, typically in the pelvis, thigh, or lower leg.

What do long trips, surgery, and pregnancy have in common? They all increase risk of deep vein thrombosis (DVT), a serious condition affecting between one and two million Americans each year.  Other risk factors for DVT include obesity, smoking, oral contraceptive use, cancer, being sedentary, and injury or illness.

DVT is a blood clot that develops in a deep vein in the body, typically in the pelvis, thigh, or lower leg. It often has no symptoms, though it sometimes causes pain, heat, or swelling at the site of the clot. The most serious complication from DVT is pulmonary embolism (PE). For patients stricken by PE, the DVT clot breaks off from the wall of the deep vein, enters the bloodstream, and travels to the lungs, blocking blood flow and causing severe shortness of breath and chest pain. PE can lead to heart failure and to serious kidney and liver damage.  It can be fatal.

“PE accounts for 100,000 to 200,000 deaths per year in the United States alone,” says Dr. Samuel Z. Goldhaber, director of the Thrombosis Research Group at Brigham and Women’s Hospital (BWH) and founder of the North American Thrombosis Forum (NATF). “The good news is that DVT and PE can be treated, if recognized early, and risks can be minimized to prevent these conditions.”

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