J. Hirsh

Publications791
h-index137
Citations74,700
Highly Influential Citations1,700
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Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
TLDR
This article describes the antithrombotic effect of the VKAs, the monitoring of anticoagulation intensity, and the clinical applications of VKA therapy and provides specific management recommendations. Expand
Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety.
TLDR
This chapter will review the mechanisms of action of heparin and LMWHs, their pharmacokinetics, anticoagulant effects, side effects, and laboratory monitoring, and the results of clinical trials will be discussed. Expand
Heparin and low-molecular-weight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.
TLDR
It has been determined that UFH infusion is preferable to LMWH injection in patients with creatinine clearance of < 25 mL/min, until further data on therapeutic dosing of LMWHs in renal failure have been published. Expand
Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer.
TLDR
The combination of a score < or =4.0 by the authors' simple clinical prediction rule and a negative SimpliRED D-Dimer result may safely exclude PE in a large proportion of patients with suspected PE. Expand
The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.
TLDR
The article describes the antithrombotic effect ofVKAs, the monitoring of anticoagulation intensity, the clinical applications of VKA therapy, and the optimal therapeutic range of VKAs, and provides specific management recommendations. Expand
Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
TLDR
Three parenteral direct thrombin inhibitors and danaparoid are approved as alternatives to heparin in HIT patients and fondaparinux binds only to antithrombin; therefore, HIT and osteoporosis are unlikely to occur. Expand
Use of a Clinical Model for Safe Management of Patients with Suspected Pulmonary Embolism
TLDR
The optimal strategy for investigating patients with suspected pulmonary embolism should combine clinical assessment, ventilation-perfusion scanning, and venous ultrasonography of the lower extremities, and the group developed a useful clinical model by reviewing the literature and coming to a consensus on a scoring system. Expand
American Heart Association/American College of Cardiology Foundation guide to warfarin therapy.
TLDR
Warfarin produces an anticoagulant effect by interfering with the cyclic interconversion of vitamin K and its 2,3 epoxide (vitamin K epoxide) and promotes binding of the vitamin K–dependent coagulation factors to phospholipid surfaces, thereby accelerating blood coagulations. Expand
Managing oral anticoagulant therapy.
TLDR
Evidence is reviews the evidence that indicates that an organized approach to anticoagulant management leads to better outcomes and focuses on dosing management and models of care. Expand
A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome.
TLDR
The low rate of recurrent thrombosis among patients in whom the target INR was 2.0 to 3.0 suggests that moderate-intensity warfarin is appropriate for patients with the antiphospholipid antibody syndrome. Expand
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