Choosing a Parenteral Anticoagulant Agent

Abstract

For decades, if a patient required a parenteral anticoagulant agent, the choice was simple: unfractionated heparin was the only such agent available. Unfractionated heparin has a long track record of effectiveness in both the treatment of and prophylaxis against arterial and venous thromboembolic disease. However, because of differences among batches of heparin and problems related to the bioavailability of the drug, monitoring of the anticoagulant effect of heparin has been not only necessary but also problematic. In addition, heparin-induced bleeding and thrombocytopenia can threaten life and limb. Moreover, there have always been problems with the use of unfractionated heparin to . . .