Differential inhibition of thrombin generation by vitamin K antagonists alone and associated with low-molecular weight heparin

摘要

Vitamin K antagonists (VKA) are the cornerstone for long-term treatment of venous thromboembolism and prevention of thrombosis in patients suffering from a wide variety of throm-boembolic diseases. Generally, oral anticoagulant therapy was started with co-administration of unfractionated heparins or low-molecular-weight heparins (LMWH) until the international normalized ratio reaches the therapeutic level for at least two concomitant days. The true degree of anticoagulation induced by combined treatment with LMWH and VKA is not known because the available clotting tests are not sensitive to the effect of both VKA (prothrombin time) and heparin (activated partial thromboplastin time).