SEVEN ARGUMENTS AGAINST STARTING WARFARIN ON THE FIRST DAY OF PULMONARY THROMBOEMBOLISM

Goran P. Koraćević, Miloš Zdravković

DOI Number
https://doi.org/10.22190/FUMB201025003K
First page
09
Last page
14

Abstract


The aim is to analyze how the advances in pulmonary thromboembolism (PTE) may influence its therapeutic protocol, focusing on the anti-vitamin K (AVK) start. Narrative review (analyzing the most important Guidelines) was used for the synthesis of the improved approach regarding the time to start AVK in PTE. For PTE, it is crucial to instantly provide an optimal anticoagulant effect of both unfractionated heparin and AVK, a difficult task indeed. By delaying AVK we may avoid the AVK use (and thus the overlap); instead, following a parenteral anticoagulant, we may proceed with direct oral anticoagulant-DOAC (if the escalation therapy is not needed). There are seven new important arguments to postpone AVK commencement from the first day of PTE treatment (although recommended in contemporary guidelines for PTE patients who are not planned for thrombolysis). A more appropriate time to start the oral anticoagulant (preferably-DOAC) is when PTE comes under control and the need for escalation of fibirinolytic treatment is gone.

Keywords

oral anticoagulants, warfarin, pulmonary thromboembolism

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References


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DOI: https://doi.org/10.22190/FUMB201025003K

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