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2016 ; 8
(ä): 87-95
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Pulmonary embolism: new treatments for an old problem
#MMPMID27843361
Ryan J
Open Access Emerg Med
2016[]; 8
(ä): 87-95
PMID27843361
show ga
Nonvitamin K antagonist oral anticoagulants, previously referred to as novel oral
anticoagulants, have emerged in recent years as attractive treatment options for
acute pulmonary embolism (PE). However, despite the widespread anticipation by
physicians and the approval of rivaroxaban, apixaban, dabigatran, and more
recently edoxaban, there is still some reluctance to choose these newer agents
over conventional treatment with heparin/vitamin K antagonists. Acute PE puts a
considerable strain on emergency departments, and medical staff rely on efficient
diagnosis and risk assessment to manage the condition appropriately and
economically. Rivaroxaban and apixaban offer a convenient and cost-effective
single-drug therapeutic approach. The ease of administration and drug management
may enable earlier discharge and outpatient treatment in low-risk patients and
alleviate the demands put on emergency-care infrastructures. This review
discusses the current guidelines and anticoagulation options in the emergency
setting for patients with acute PE and explores the reasons for the slow
transition from old to new treatment options.