ABSTRACT
Anticoagulants have been a part of the medical armamentarium for more than 50 years.
These drugs inhibit thrombosis, which is the incipient event in many cardiovascular
diseases such as myocardial infarction, stroke, and peripheral arterial disease. Thrombus
embolization from the atria can occur in association with atrial fibrillation (AF), from the
ventricles in congestive heart failure and cardiomyopathy, from the valve surfaces in
valvular heart disease, and from the diseased vessels in peripheral arterial disease, causing
stroke and/or gangrenous limbs. Similarly, venous thrombosis and embolization also
produces significant cardiovascular disease, peripheral venous disease, and pulmonary
emboli. The clinical indications for the use of anticoagulants in each of these disease
states, described in detail in prior chapters, are summarized below. This chapter will
discuss the different therapeutic options, the pharmacologic basis for these therapies, and
the management of therapy in different cohorts of patients.
