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INTRODUCTION

Antithrombotic therapy (i.e., anticoagulants, antiplatelet agents, and fibrinolytics) is used to treat or reduce the risk of arterial and venous thromboembolic conditions, including acute coronary syndrome, deep venous thrombosis and pulmonary embolism (collectively, venous thromboembolic disease), transient ischemic attack, and ischemic stroke (Table 239-1). Moreover, antithrombotic agents help prevent occlusive vascular events in patients at risk for thrombosis due to atherosclerotic arterial disease, atrial fibrillation, medical illness with immobility, or surgical insult. These agents, however, can cause life-threatening complications, primarily serious or life-threatening hemorrhage. Detailed management strategies for thromboembolic disorders are discussed in their respective chapters (see Chapter 49, “Acute Coronary Syndromes”; Chapter 56, “Venous Thromboembolism Including Pulmonary Embolism”; and Chapter 167, “Stroke Syndromes”).

TABLE 239-1Indications for Antithrombotic Therapy

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