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REVIEW
Year : 2013  |  Volume : 5  |  Issue : 5  |  Page : 254-260

Management of venous thrombo-embolism: From leeches to novel oral anticoagulants


Division of Internal Medicine, Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates

Correspondence Address:
Bisher Oscar Mustafa
Division of Internal Medicine, Institute of Medicine, Sheikh Khalifa Medical City, Abu Dhabi
United Arab Emirates
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-489X.210554

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Venous thromboembolism (VTE) is one of the three major cardiovascular causes of death, but the history of venous thrombosis in miniature illustrates the development of medicine itself. Anticoagulation therapy has a long history. It started with leeches and passed through heparin, warfarin and low molecular weight heparin (LMWH). The development of the novel oral anticoagulants (NOACs) has marked the beginning of a new era in the treatment of VTE. Dabigatran, Rivaroxaban and Apixaban has been approved for different indications of anticoagulation which include non valvualr atrial fibrillation, venous thromboembolism prophylaxis and treatment. Use of these agents requires expertise in managing the dose and their adjustment in special cases like renal insufficiency as these agents carry risk of bleeding and proper antidote is still being developed. Knowledge of NOACs is essential for all medical personal as these agents are the future of the anticoagulation and they are set to replace warfarin and LMWH on the long term.


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