Vitamin K antagonists in heart disease: Current status and perspectives (Section III). Position Paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease.

Details

Serval ID
serval:BIB_B8E87BBD0B2A
Type
Article: article from journal or magazin.
Collection
Publications
Title
Vitamin K antagonists in heart disease: Current status and perspectives (Section III). Position Paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease.
Journal
Thrombosis and Haemostasis
Author(s)
De Caterina R., Husted S., Wallentin L., Andreotti F., Arnesen H., Bachmann F., Baigent C., Huber K., Jespersen J., Kristensen S.D., Lip G.Y., Morais J., Rasmussen L.H., Siegbahn A., Verheugt F.W., Weitz J.I.
ISSN
0340-6245 (Print)
ISSN-L
0340-6245
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
110
Number
6
Pages
1087-1107
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
Oral anticoagulants are a mainstay of cardiovascular therapy, and for over 60 years vitamin K antagonists (VKAs) were the only available agents for long-term use. VKAs interfere with the cyclic inter-conversion of vitamin K and its 2,3 epoxide, thus inhibiting γ-carboxylation of glutamate residues at the amino-termini of vitamin K-dependent proteins, including the coagulation factors (F) II (prothrombin), VII, IX and X, as well as of the anticoagulant proteins C, S and Z. The overall effect of such interference is a dose-dependent anticoagulant effect, which has been therapeutically exploited in heart disease since the early 1950s. In this position paper, we review the mechanisms of action, pharmacological properties and side effects of VKAs, which are used in the management of cardiovascular diseases, including coronary heart disease (where their use is limited), stroke prevention in atrial fibrillation, heart valves and/or chronic heart failure. Using an evidence-based approach, we describe the results of completed clinical trials, highlight areas of uncertainty, and recommend therapeutic options for specific disorders. Although VKAs are being increasingly replaced in most patients with non-valvular atrial fibrillation by the new oral anticoagulants, which target either thrombin or FXa, the VKAs remain the agents of choice for patients with atrial fibrillation in the setting of rheumatic valvular disease and for those with mechanical heart valves.
Pubmed
Web of science
Create date
12/01/2014 16:50
Last modification date
20/08/2019 15:26
Usage data