Pharmacological Options

Complications of Treatment

Bleeding risk

The major complication of antithrombotic therapy is bleeding.  For each antithrombotic drug, the antithrombotic efficacy must be balanced against the potential increased bleeding risk. 

Clinical trials distinguish:

The criteria for defining the severity of bleeding vary considerably between studies, accounting in part for the variation in the rates of bleeding reported.

Heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia (HIT) is a severe immuno-allergic adverse effect of heparin therapy mediated by antibodies, mostly antibodies against PF4 (platelet factor 4)/heparin complexes. HIT is most common in patients receiving UFH (0.5 to 5%), but also occurs in patients receiving LMWH (Jang and Hursting. Circulation 2005;111:2672-83).

Thrombosis rather than haemorrhage is the predominant clinical sign.  If untreated:

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