Eficácia do uso de terapia anticoagulante na prevenção de trombose venosa em pacientes hospitalizados
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Resumo
Objetivo: Analisar a eficácia da terapia anticoagulante na prevenção de trombose venosa em pacientes internados, com ênfase na diminuição de eventos tromboembólicos e na redução das complicações associadas ao tratamento. Métodos: Trata-se de uma revisão integrativa da literatura realizada através de buscas nas bases de dados PubMED e BVS, utilizando os descritores ”Anticoagulant” “Thrombosis” e “Patient”, em conjunto com o operador booleano “AND”. Foram incluídos artigos publicados nos últimos 5 anos, disponíveis na íntegra e que atendiam ao objetivo de pesquisa. Resultados: O estudo destaca a importância de individualizar o uso de anticoagulantes para prevenir trombose venosa em pacientes hospitalizados, especialmente em grupos de risco como idosos e pacientes com câncer. Terapias como rivaroxabana, enoxaparina, mesoglicano e milvexian apresentam perfis de eficácia e segurança variados, exigindo ajustes conforme a condição clínica. Em pacientes com fibrilação atrial ou submetidos a procedimentos invasivos, a escolha entre monoterapia e terapia combinada deve considerar o risco de sangramento e o perfil do paciente. Considerações finais: A profilaxia e o tratamento da trombose venosa são essenciais na prática clínica, exigindo uma escolha cuidadosa e individualizada de anticoagulantes conforme o perfil e contexto clínico de cada paciente, visando a eficácia e segurança de cada medicamento.
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Referências
2. CAMPORESE G, et al. Mesoglycan for the secondary prevention of superficial vein thrombosis: a randomized, controlled, double-blind study (METRO Study) - rationale and protocol. Journal of thrombosis and thrombolysis, 2024; 57(2): 226–234.
3. DELLA ROCCA DG, et al. Half-dose direct oral anticoagulation versus standard antithrombotic therapy after left atrial appendage occlusion. JACC. Cardiovascular interventions, 2021; 14(21): 2353–2364.
4. HU X, et al. Early 6 months usage of single anTiplAtelet OR anTicoAgulant followed by single antiplatelet after transcatheter aortic valve replacement: protocol for a multicentre, open-label, randomised controlled clinical trial. BMJ open, 2023; 13(11): 76781.
5. HU YC, et al. Bivalirudin in patients undergoing percutaneous coronary intervention and independent predictors of postoperative adverse events in these patients: A real world retrospective study: A real world retrospective study. Medicine, 2021; 100(10): 25003.
6. HUANG YC, et al. Choice of antithrombotic therapy for patients with atrial fibrillation undergoing carotid angioplasty and stenting: a nationwide population-based study. Scientific reports, 2022; 12(1): 1417.
7. KLOK FA e HUISMAN MV. How I assess and manage the risk of bleeding in patients treated for venous thromboembolism. Blood, 2020; 135(10): 724–734.
8. KOPJAR T, et al. Comparison of apixaban versus aspirin for the prevention of latent bioprosthetic aortic valve thrombosis: study protocol for a prospective randomized trial. Trials, 2024; 25(1): 324.
9. KOVACS MJ, et al. Postoperative low molecular weight heparin bridging treatment for patients at high risk of arterial thromboembolism (PERIOP2): double blind randomised controlled trial.BMJ (Clinical research ed.), 2021; 373: 1205.
10. KURODA S, et al. Efficacy and safety of short-term (3 days) enoxaparin in preventing venous thromboembolism after gastric cancer surgery: A single-center, prospective cohort study. International journal of surgery (London, England), 2021; 89(105946): 105946.
11. LI M, et al. An efficacy and safety study of rivaroxaban for the prevention of deep vein thrombosis in patients with left iliac vein compression treated with stent implantation (PLICTS): study protocol for a prospective randomized controlled trial. Trials, 2020; 21(1): 811.
12. LIU X, et al. Efficacy and safety of bivalirudin vs heparin in patients with coronary heart disease undergoing percutaneous coronary intervention: A meta-analysis of randomized controlled trials. Medicine, 2020; 99(6): 19064.
13. LOBASTOV K, et al. A systematic review and meta-analysis for the association between duration of anticoagulation therapy and the risk of venous thromboembolism in patients with lower limb superficial venous thrombosis. Journal of vascular surgery. Venous and lymphatic disorders, 2024; 12(2): 101726.
14. MALLADI S, et al. Management of stable coronary artery disease and atrial fibrillation with anti-thrombotic therapy: A systematic review and meta-analysis: A systematic review and meta-analysis. Medicine, 2021; 100(48): 27498.
15. PARK J, et al. Outcomes in relation to antithrombotic therapy among patients with atrial fibrillation after percutaneous coronary intervention. PloS one, 2020; 15(10): 240161.
16. PETCH J, et al. Optimizing warfarin dosing for patients with atrial fibrillation using machine learning. Scientific reports, 2024; 14(1): 4516.
17. QIAN C, et al. Early vs. late enoxaparin for the prevention of venous thromboembolism in patients with ICH: A double blind placebo controlled multicenter study. Clinical neurology and neurosurgery, 2021; 202(106534): 106534.
18. SIDHU VS, et al. CRISTAL: protocol for a cluster randomised, crossover, non-inferiority trial of aspirin compared to low molecular weight heparin for venous thromboembolism prophylaxis in hip or knee arthroplasty, a registry nested study. BMJ open, 2019; 9(11): 31657.
19. SONG R, et al. Comparison of the efficacy of rivaroxaban and dabigatran etexilate in preventing venous thrombosis after arthroplasty: A protocol of randomized controlled trial: A protocol of randomized controlled trial. Medicine, 2021; 100(1): 23814.
20. SPYROPOULOS A, et al. Post-discharge prophylaxis with rivaroxaban reduces fatal and major thromboembolic events in medically ill patients. Journal of the American College of Cardiology, 2020; 75(25): 3140–3147.
21. SPYROPOULOS A, et al. Scientific and Standardization Committee Communication: Guidance document on the periprocedural management of patients on chronic oral anticoagulant therapy: Recommendations for standardized reporting of procedural/surgical bleed risk and patient-specific thromboembolic risk. Journal of thrombosis and haemostasis: JTH, 2019; 17(11): 1966–1972.
22. UNVERDORBEN M, et al. Elderly patients with atrial fibrillation in routine clinical practice-peri-procedural management of edoxaban oral anticoagulation therapy is associated with a low risk of bleeding and thromboembolic complications: a subset analysis of the prospective, observational, multinational EMIT-AF study. BMC cardiovascular disorders, 2020; 20(1): 504.
23. WANG T, et al. The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients: Guidance from the SSC of the ISTH. Journal of thrombosis and haemostasis: JTH, 2019; 17(10): 1772–1778.
24. WEITZ J, et al. Milvexian for the prevention of venous thromboembolism. The New England journal of medicine, 2021; 385(23): 2161–2172.
25. WEITZ J. et al. Thromboprophylaxis with rivaroxaban in acutely ill medical patients with renal impairment: Insights from the MAGELLAN and MARINER trials. Thrombosis and haemostasis, 2020; 120(3): 515–524.
26. WOLLER SC, et al. Apixaban compared with warfarin to prevent thrombosis in thrombotic antiphospholipid syndrome: a randomized trial. Blood advances, 2022; 6(6): 1661–1670.