Coumarins have been widely used for the prevention of arterial and venous thromboembolism. The importance of oral anticoagulants has steadily increased in internal medicine and cardiology in the past 20 years. Coumarins are vitamin K antagonists by inhibiting the synthesis of vitamin K-dependent coagulation factors in liver cells. Since the average half-life of hydroxy-coumarin is longer than that of aceno-coumarin, the INR of patients treated with hydroxy-coumarin is more stable, thus making it especially suitable for long-term anticoagulant treatment. The main indications of coumarin therapy include secondary prophylaxis of venous thromboembolism, and primary and secondary prevention of arterial thromboembolism, particularly embolic stoke, in patients with cardiovascular disorders. This review summarizes the most important clinical issues of long-term oral anticoagulant therapy including indications, contraindications, dosing, therapeutic range, and laboratory monitoring. Special emphasis is placed on the role of hydroxy-coumarin in long-term oral anticoagulant therapy.
|Number of pages||8|
|Journal||Lege Artis Medicinae|
|Publication status||Published - Mar 1 2006|
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