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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El tratamiento anticoagulante ha estado basado en las heparinas y los antagonistas de la vitamina K durante los &#250;ltimos 60 a&#241;os&#46; En la actualidad existen nuevos anticoagulantes como dabigatran&#44; rivaroxaban y apixaban que poseen ventajas importantes frente al tratamiento cl&#225;sico&#46; Estos f&#225;rmacos est&#225;n dirigidos a un solo factor de la cascada de la coagulaci&#243;n y se administran por v&#237;a oral y a dosis fija&#46; Adem&#225;s&#44; no precisan monitorizaci&#243;n de su efecto de forma rutinaria&#44; el comienzo de su acci&#243;n es r&#225;pido&#44; la vida media corta y no presentan interferencias con los alimentos&#44; aunque se han descrito interacciones con algunos f&#225;rmacos&#46; De momento no se dispone de ant&#237;doto espec&#237;fico&#44; pero su vida media corta lo hace menos imprescindible&#46; Han demostrado una eficacia y seguridad similares&#44; o incluso superiores&#44; al tratamiento cl&#225;sico en la prevenci&#243;n del tromboembolismo venoso en los enfermos sometidos a cirug&#237;a ortop&#233;dica de rodilla o cadera&#44; y en la prevenci&#243;n del ictus y del embolismo sist&#233;mico en la fibrilaci&#243;n auricular no valvular&#46; Dabigatran y rivaroxaban tambi&#233;n han demostrado su eficacia en el tratamiento de la enfermedad tromboemb&#243;lica venosa&#46; Las caracter&#237;sticas de estos f&#225;rmacos los convierten en una opci&#243;n muy atractiva para sustituir a las heparinas y&#44; especialmente&#44; a los antagonistas de la vitamina K de forma progresiva y prudente&#46; Muchos de nuestros enfermos van a poder olvidarse del tratamiento anticoagulante cl&#225;sico y&#44; sobre todo&#44; muchos de ellos ni siquiera van a conocerlo&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">For the last 60 years&#44; heparin and vitamin K antagonists have been the cornerstone of anticoagulation&#46; Nowadays&#44; the new anticoagulants&#44; such as dabigatran&#44; rivaroxaban and apixaban&#44; show potential advantages over classical treatments&#46; These agents inhibit specific coagulation factors and are administered orally at fixed doses&#46; Furthermore&#44; heparin and vitamin K antagonists have a fast onset of action&#44; shortduration and predictable therapeutic effects&#46; No interactions with foods have been described&#44; although some drug-drug interactions have been reported&#46; At the moment&#44; no antidotes are available&#46; However&#44; due to the short half-life of these agents&#44; antidotes are less essential&#46; The new anticoagulants are at least as effective and safe as traditional treatments in the prevention of venous thromboembolism after orthopedic surgery&#44; as well as in the prevention of stroke and systemic embolism in non-valvular atrial fibrillation&#46; Dabigatran and rivaroxaban have also been shown to be effective in the treatment of acute venous thromboembolism&#46; Due to their properties&#44; these drugs could gradually replace heparin and especially vitamin K antagonists&#46; Hopefully&#44; many of our patients will be able to discontinue classical anticoagulant treatment and others will never begin it&#46;</p>"
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Vol. 212. Núm. S1.
Novedades en anticoagulación. ¿Nos olvidamos ya de la heparina y las antivitaminas K?
Páginas 3-7 (enero 2011)
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Vol. 212. Núm. S1.
Novedades en anticoagulación. ¿Nos olvidamos ya de la heparina y las antivitaminas K?
Páginas 3-7 (enero 2011)
Novedades en anticoagulación. ¿Nos olvidamos ya de la heparina y las antivitaminas K? Sí
New advances in anticoagulation: is it time to forget about heparin and vitamin K antagonists? Yes
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4
A. Blanco-Molina
Unidad Clínica de Gestión de Medicina Interna, Hospital Universitario Reina Sofía, Córdoba, España
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Resumen

El tratamiento anticoagulante ha estado basado en las heparinas y los antagonistas de la vitamina K durante los últimos 60 años. En la actualidad existen nuevos anticoagulantes como dabigatran, rivaroxaban y apixaban que poseen ventajas importantes frente al tratamiento clásico. Estos fármacos están dirigidos a un solo factor de la cascada de la coagulación y se administran por vía oral y a dosis fija. Además, no precisan monitorización de su efecto de forma rutinaria, el comienzo de su acción es rápido, la vida media corta y no presentan interferencias con los alimentos, aunque se han descrito interacciones con algunos fármacos. De momento no se dispone de antídoto específico, pero su vida media corta lo hace menos imprescindible. Han demostrado una eficacia y seguridad similares, o incluso superiores, al tratamiento clásico en la prevención del tromboembolismo venoso en los enfermos sometidos a cirugía ortopédica de rodilla o cadera, y en la prevención del ictus y del embolismo sistémico en la fibrilación auricular no valvular. Dabigatran y rivaroxaban también han demostrado su eficacia en el tratamiento de la enfermedad tromboembólica venosa. Las características de estos fármacos los convierten en una opción muy atractiva para sustituir a las heparinas y, especialmente, a los antagonistas de la vitamina K de forma progresiva y prudente. Muchos de nuestros enfermos van a poder olvidarse del tratamiento anticoagulante clásico y, sobre todo, muchos de ellos ni siquiera van a conocerlo.

Palabras clave:
Apixaban
Antagonistas vitamina K
Dabigatran
Enfermedad tromboembólica venosa
Heparinas
Rivaroxaban
Fibrilación auricular
Abstract

For the last 60 years, heparin and vitamin K antagonists have been the cornerstone of anticoagulation. Nowadays, the new anticoagulants, such as dabigatran, rivaroxaban and apixaban, show potential advantages over classical treatments. These agents inhibit specific coagulation factors and are administered orally at fixed doses. Furthermore, heparin and vitamin K antagonists have a fast onset of action, shortduration and predictable therapeutic effects. No interactions with foods have been described, although some drug-drug interactions have been reported. At the moment, no antidotes are available. However, due to the short half-life of these agents, antidotes are less essential. The new anticoagulants are at least as effective and safe as traditional treatments in the prevention of venous thromboembolism after orthopedic surgery, as well as in the prevention of stroke and systemic embolism in non-valvular atrial fibrillation. Dabigatran and rivaroxaban have also been shown to be effective in the treatment of acute venous thromboembolism. Due to their properties, these drugs could gradually replace heparin and especially vitamin K antagonists. Hopefully, many of our patients will be able to discontinue classical anticoagulant treatment and others will never begin it.

Keywords:
Apixaban
Vitamin K antagonists
Dabigatran
Venous thromboembolic disease
Heparin
Rivaroxaban
Atrial fibrillation

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