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Antithrombotic Therapy for Venous Thromboembolic Disease

Thomas M. Hyers, MD, FCCP, Chair; Giancarlo Agnelli, MD; Russell D. Hull, MBBS, MSc, FCCP; Timothy A. Morris, MD, FCCP; Michel Samama, MD; Victor Tapson, MD, FCCP; John G. Weg, MD, FCCP
Author and Funding Information

Correspondence to: Thomas M. Hyers, MD, FCCP, Occupational Medicine and Pulmonary Diseases, 533 Couch Ave, Suite 140, St. Louis, MO 63122



Chest. 2001;119(1_suppl):176S-193S. doi:10.1378/chest.119.1_suppl.176S
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Stasis of blood, abnormalities of the vessel wall, and changes in the soluble and formed elements of the blood are the major contributors to thrombosis. All of these alterations can contribute to venous thrombosis, depending on the specific risk factors that are present in a given patient.

Antithrombotic regimens modify one or more of these abnormalities. These regimens include drugs that inhibit blood coagulation, such as the various heparins and heparinoids; warfarin; direct thrombin inhibitors; drugs that inhibit platelet function, such as aspirin and dextran; and techniques that counteract venous stasis, such as compression stockings and pneumatic compression devices. In this broad sense, thrombolytic agents are also antithrombotic (Table 1 ). This section will describe the effectiveness of antithrombotic agents in the treatment of venous thromboembolism (VTE), a disease that encompasses both deep venous thrombosis (DVT) and pulmonary embolism (PE). Several of these agents are also useful for the primary prevention of VTE, and this application of antithrombotic therapy is reviewed in the preceding chapter.

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