sanorg-34006 and Heart-Failure

Modern approaches to prevention of venous thromboembolic complications in patients with chronic heart failure are analyzed in this review which contains results of large studies of low molecular weight heparins. In MEDENOX trial the use of enoxaparin in medical patients was associated with 63% reduction of risk of thrombosis. The authors own experience showed that 2 weeks of therapy with enoxaparin in patients with chronic stage IIB-III heart failure caused significant lowering of soluble fibrin-monomer complexes, fibrinogen, and index of turbo-dynamic potential. These changes evidenced for decreased intravascular blood coagulation. Thus enoxaparin can be effectively used for prevention of thrombosis and thromboembolism in patients with chronic heart failure. Novel antithrombotic agents fondaparinux, idraparinux, ximelagatran, recombinant thrombomodulin are perspective medications for prevention of venous thromboses and embolism in medical patients.

Topics: Anticoagulants; Azetidines; Benzylamines; Dalteparin; Double-Blind Method; Enoxaparin; Fibrinolytic Agents; Fondaparinux; Heart Failure; Humans; Multicenter Studies as Topic; Oligosaccharides; Placebos; Polysaccharides; Randomized Controlled Trials as Topic; Risk Factors; Thromboembolism; Thrombomodulin; Thrombosis; Time Factors; Venous Thrombosis

This paper summarizes several important studies published during the previous year that have an impact on the practice of inpatient internal medicine, because they either modify or reinforce current practices. The selected domains include the treatment of thrombo-embolic disease, the role of implantable defibrillators in left cardiac failure, the management of cerebro-vascular disease, of community-acquired pneumonia, and of type 2 diabetes, as well as the prevention of spontaneous bacterial peritonitis in cirrhosis and of osteoporosis fractures. Some data stimulating our reflection on the integration of medical education in health care centres and on the validity of some scientific publications are also presented.

Topics: Anti-Bacterial Agents; Anticoagulants; Benzimidazoles; Bone Density Conservation Agents; Community-Acquired Infections; Coronary Disease; Dabigatran; Defibrillators, Implantable; Diabetes Mellitus, Type 2; Fractures, Bone; Heart Failure; Heart Neoplasms; Hip Prosthesis; Hospital Departments; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypoglycemic Agents; Internal Medicine; Liver Cirrhosis; Oligosaccharides; Osteoporosis; Peritonitis; Pneumonia, Bacterial; Pulmonary Embolism; Pyridines; Quality of Health Care; Risk Factors; Stroke; Teaching; Tomography, X-Ray Computed; Venous Thrombosis