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Acute pulmonary embolism: risk assessment, risk stratification and treatment options

机译:急性肺栓塞:风险评估,风险分层和治疗选择

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IntroductionPulmonary embolism (PE) is a potentially life-threatening cardiovascular emergency with a high mortality rate. Rapid diagnosis and treatment are important in optimising clinical outcomes in patients with PE, and anticoagulants are the mainstay of treatment. Traditionally, anticoagulant therapy involves parenteral anticoagulants, overlapping with and followed by oral vitamin K antagonists. Direct oral anticoagulants (DOACs), including the factor Xa inhibitors rivaroxaban, apixaban and edoxaban, and the direct thrombin inhibitor dabigatran etexilate, have been developed to address limitations associated with traditional anticoagulant therapy. Apixaban, dabigatran and rivaroxaban have recently been approved for the treatment of acute deep vein thrombosis (DVT) and PE and prevention of recurrent DVT or PE. Edoxaban is approved in the United States but not currently in the European Union for the treatment of DVT and PE; approval of edoxaban in Europe is anticipated in the near future.
机译:引言肺栓塞(PE)是一种潜在的威胁生命的心血管急症,死亡率很高。快速诊断和治疗对优化PE患者的临床结局非常重要,抗凝剂是治疗的主要手段。传统上,抗凝疗法涉及肠胃外抗凝剂,与口服维生素K拮抗剂重叠并随后口服。已经开发出包括因子Xa抑制剂利伐沙班,阿哌沙班和依多沙班的直接口服抗凝剂(DOAC),以及直接凝血酶抑制剂达比加群酯,以解决与传统抗凝治疗相关的局限性。阿哌沙班,达比加群和利伐沙班最近已被批准用于治疗急性深静脉血栓形成(DVT)和PE和预防DVT或PE复发。 Edoxaban已在美国获得批准,但目前尚未在欧盟批准用于DVT和PE的治疗;预计不久的将来埃多沙班将在欧洲获得批准。

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