Role of Direct Oral Anticoagulants for Post-operative Venous Thromboembolism Prophylaxis

Han Naung Tun; May Thu Kyaw; Erik Rafflenbeul; Xiuhtlaulli López Suástegui

doi:10.15420/ecr.2021.55

Role of Direct Oral Anticoagulants for Post-operative Venous Thromboembolism Prophylaxis

Eur Cardiol. 2022 May 13:17:e11. doi: 10.15420/ecr.2021.55. eCollection 2022 Feb.

Authors

Han Naung Tun¹, May Thu Kyaw², Erik Rafflenbeul³, Xiuhtlaulli López Suástegui⁴

Affiliations

¹ Larner College of Medicine, University of Vermont Burlington, VT, US.
² Heart and Vascular Centre, Victoria Hospital Yangon, Myanmar.
³ Department of Cardiology, Schoen Clinic Hamburg Eilbek Hamburg, Germany.
⁴ Emergency Department, Intensive Care Unit Hospital Regional de Alta Especialidad de Zumpango, Instituto Mexicano del Seguro Social Zumpango de Ocampo, Mexico.

Abstract

Venous thromboembolism (VTE) is one of the leading causes of post-operative morbidity and mortality. Over previous decades, heparin and warfarin were the predominant therapeutic options for post-operative thromboprophylaxis. However, their use is limited by drawbacks including a narrow therapeutic range, numerous food and drug interactions, and the need for regular monitoring for dose adjustments. Recently, direct oral anticoagulants (DOACs), such as dabigatran etexilate (a direct thrombin inhibitor) and apixaban, rivaroxaban and edoxaban (direct factor Xa inhibitors), have been developed to overcome these issues. DOACs have shown promising results in Phase III clinical trials for post-operative VTE prophylaxis. This review summarises the pharmacological profile of DOACs and highlights the use of DOACs in post-operative VTE prophylaxis based on the available clinical trial data.

Keywords: Direct oral anticoagulants; deep vein thrombosis; post-operative; venous thromboembolism.

Publication types

Review