, an important complication of atherosclerosis and of various medical
and surgical conditions, can be prevented or treated effectively by a
variety of pharmacologic agents. Three classes of agents are available:
anticoagulants, antiplatelet agents, and thrombolytic drugs. The first
two prevent the formation and growth of thrombi, whereas the third
lyses existing thrombi.
The American College of Chest Physicians (ACCP) Task Force on
Antithrombotic Therapy published the proceedings of their first
consensus conference on antithrombotic therapy in 1986.1
The participants introduced a system of evidence that has served as a
model for critically appraising the literature and has been adopted by
many medical organizations. In the 14 years since the first conference,
the field of antithrombotic therapy has witnessed enormous growth, due
in part to the development of new and more powerful pharmacologic
agents and in part to the evaluation of these agents in well-designed
clinical trials. The proceedings of the sixth ACCP Consensus Conference
provide an extensive critical review of the literature related to
management of thromboembolic disorders, including venous
thromboembolism, arterial thrombosis, and systemic arterial embolism.
As in past reports, each section concludes with a detailed summary that
documents the therapeutic recommendations, assigns a grade for each
recommendation (1 or 2), and proffers the strength of the evidence on
which the recommendations are based (A,B,C, or C+).