Pulmonary embolism and direct oral anticoagulants

Abstract

A new European guideline for the diagnostics and therapy of venous thromboembolism has been published in 2014. As previously, high-risk and low-risk pulmonary embolism is distinguished, however, in the new guideline there is also a definition of intermediate risk PE. The risk finally decides about the diagnostic and therapeutic procedure. Previously, nearly only heparinoids were available for therapy of acute venous thromboembolism and after some days they were switched to a vitamin K antagonist. The direct oral anticoagulants (DOAC) represent a group of drugs that start working as rapidly as heparinoids and can be applied as long-term oral medication. In contrast to vitamin K antagonists, repeated coagulation tests are not necessary. Dosing is easy, although in quite a few cases dose adaptations compared to the standard dose may be necessary. The following article tries to give a rapid orientation.