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Vol. 6. Núm. H.
Avances en el tratamiento antitrombótico en el intervencionismo coronario percutáneo
Páginas 11H-17H (Octubre 2006)
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Vol. 6. Núm. H.
Avances en el tratamiento antitrombótico en el intervencionismo coronario percutáneo
Páginas 11H-17H (Octubre 2006)
Avances en el tratamiento antitrombótico en el intervencionismo coronario percutáneo
DOI: 10.1016/S1131-3587(06)74840-3
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Anticoagulación durante el intervencionismo coronario
Anticoagulation in Percutaneous Coronary Intervention
Visitas
...
Iñigo Lozano, Pablo Avanzas, César Morís??
Autor para correspondencia
cesar.moris@sespa.princast.es

Correspondencia: Dr. C. Morís. Área del Corazón. Hospital Universitario Central de Asturias. Celestino Villamil, s/n. 33006 Oviedo. España.
Hospital Universitario Central de Asturias. Oviedo. España
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Un apartado esencial del intervencionismo coronario percutáneo es la terapia anticoagulante. A pesar de la constante evolución de las técnicas percutáneas, la heparina no fraccionada continúa siendo la terapia más utilizada, debido fundamentalmente a la tradición y a la comodidad de su uso. Sin embargo, su utilización presenta inconvenientes, como la variabilidad en el efecto, la necesidad de controlarlo y la capacidad de activación de las plaquetas. Se dispone de otros fármacos que o bien han demostrado eficacia y seguridad o están en evaluación como alternativas a la heparina en el futuro. Nos referimos a las heparinas de bajo peso molecular, los inhibidores directos de la trombina y los pentasacáridos. En este capítulo se analizan los diferentes regímenes de anticoagulación con heparina no fraccionada, heparinas de bajo peso molecular y pentasacáridos. Los inhibidores directos de la trombina serán tratados en un capítulo posterior.

Palabras clave:
Anticoagulantes
Angioplastia coronaria
Fármacos
Stent
Abreviaturas:
ICP
HBPM
HNF
SCACEST
SCASEST

Anticoagulation is an essential part of treatment in percutaneous coronary intervention. Despite the ongoing development of percutaneous techniques, unfractioned heparin remains the most commonly used drug, principally for historical reasons and because of familiarity with its use. However, there are some drawbacks: its effects are variable, its use must be monitored, and it can stimulate platelet activation. Today, there are a number of alternative drugs that could replace heparin in the future and whose efficacy and safety have either been demonstrated or are currently being investigated. These include low-molecular-weight heparins, direct thrombin inhibitors, and pentasaccharides. This article contains a discussion of anticoagulation regimens involving unfractioned heparin, low-molecular-weight heparins, and pentasaccharides. Direct thrombin inhibitors are discussed later.

Key words:
Anticoagulants
Coronary angioplasty
Drugs
Stent
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