[ANMCO position paper: Use of new oral anticoagulants for the treatment and prevention of pulmonary thromboembolism].


The new oral anticoagulants (NOACs) have radically changed the approach to the treatment and prevention of thromboembolic pulmonary embolism. The authors of this position paper face, in succession, issues concerning NOACs, including 1) their mechanism of action, pharmacodynamics and pharmacokinetics; 2) the use in the acute phase with the "double drug single dose" approach or with "single drug double dose"; 3) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; 4) the encouraging use of NOACs in particular subgroups of patients such as those with cancer, the ones under- or overweight, with renal insufficiency (creatinine clearance >30 ml/min), the elderly (>75 years); 5) they propose a possible laboratory clinical pathway for follow-up; 6) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications. The authors conclude that the use of NOACs both in the acute phase and in the extended phase is equally effective to conventional therapy and associated with fewer major bleeding events, which make their use in patients at higher risk of recurrences safer.

DOI: 10.1714/2450.25668

Cite this paper

@article{Enea2016ANMCOPP, title={[ANMCO position paper: Use of new oral anticoagulants for the treatment and prevention of pulmonary thromboembolism].}, author={Iolanda Enea and Loris Roncon and Michele Massimo Gulizia and Michele Azzarito and Cecilia Becattini and Amedeo Bongarzoni and Franco Casazza and Claudio Cuccia and Carlo D'agostino and Matteo Rugolotto and Marco Vatrano and Eugenio Vinci and Paride Fenaroli and Dario Formigli and Paolo Silvestri and Federico Nardi and Maria Cristina Vedovati and Marino Scherillo}, journal={Giornale italiano di cardiologia}, year={2016}, volume={17 9 Suppl 1}, pages={29S-67} }