Management Strategies in Antithrombotic Therapy

It has become well-established that there is an enormous cost, both clinical and economic, associated with intravascular thrombosis. Understanding the central role of thrombosis in the pathogenesis of the acute coronary syndromes, ischemic complications of percutaneous coronary intervention, and venous thromboembolic disease has facilitated the rapid expansion of available antithrombotic therapies to treat these potentially life-threatening conditions. Furthermore, investigation focusing on the use of fibrinolytic therapy, antiplatelet therapy (aspirin, the thieneopyridines, glycoprotein IIb/IIIa inhibitors) and antithrombin therapy (unfractionated heparin, low-molecular-weight heparins, direct thrombin inhibitors) as well as novel combinations of these agents has resulted in a marked improvement in outcomes for patients stricken with a thrombotic event. Despite the improvement in outcomes, the burden of thrombosis remains, as does the search for improved antithrombotic therapies. 

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