The New Dimensions Of Warfarin Prophylaxis (advances In Experimental Medicine And Biology)

The International Symposium on The New Dimensions of Warfarin Prophylaxis held on October 16-18, 1986 in New York City was conceived as a forum to bring together physicians and other scientists knowledgeable about the pharmacological effects of warfarin on the hemostatic mechanism and the clinical usefulness of this compound in the prevention of thromboembolic phenomena. The coumarin compounds have commanded a striking breadth of interest among members of the biomedical research community for almost one-half century. Aspects of its effects on the vitamin K-dependent proteins, on the laboratory recognition of the drug's pharmacologic action and its use as a therapeutic agent in a variety of disease states have been actively studied with increasing intensity in the past several decades. Thus, the present state of these studies seemed to be a timely subject for discussion, not only to gather together in one place representative samples of the myriad of data on warfarin, but also to underscore the ever increasing necessity for communication between basic research and clinical practice. The content and organization of this monograph reflect the scope and importance of warfarin prophylaxis. One of the unique aspects of this publication is that it spells out in one place the warfarin story from molecular biology through clinical trials to future directions of research and patient care. Front Matter....Pages i-ix The Scope of Thromboembolism....Pages 1-2 The Biochemical Basis of Warfarin Therapy....Pages 3-16 Warfarin and the Biochemistry of the Vitamin K Dependent Proteins....Pages 17-46 Anticoagulation Proteins C and S....Pages 47-54 Warfarin and Bone: Implications for Rational Strategies to Selectively Antagonize the Action of Vitamin K in Target Tissues....Pages 55-66 Human Genes for Factor IX and other Vitamin K Dependent Blood Proteins....Pages 67-81 Tissue Factor and the Initiation of Blood Coagulation....Pages 83-94 INR — Calibration of the Therapeutic Range....Pages 95-112 Cold-Promoted Activation of Factor VII and Shortening of the Prothrombin Time....Pages 113-129 Immunologic Aspects of Vessel Injury and Thrombosis....Pages 131-147 What’s the Dose?....Pages 149-152 Venous Thromboembolism in Moderate Risk Patients....Pages 153-158 Two-Step Warfarin Therapy for the Prophylaxis of Venous Thrombosis After Elective Surgery....Pages 159-163 Prevention of Venous Thromboembolism in High-Risk Patients by Prophylactic Administration of Oral Anticoagulants....Pages 165-174 Genetic Coagulation Defects....Pages 175-186 Treatment of First Episode of Venous Thrombosis....Pages 187-193 Management of Recurrent Venous Thromboembolism....Pages 195-204 Warfarin Metabolism and Drug-Drug Interactions....Pages 205-212 Improving the Benefit/Risk Ratio....Pages 213-216 Oral Anticoagulant Therapy and Skin Necrosis: Speculations on Pathogenesis....Pages 217-222 Clinical Trials in Myocardial Infarction and Coronary Heart Disease....Pages 223-229 Anticoagulants in Acute Myocardial Infarction....Pages 231-241 Long-Term Anticoagulant Treatment After Acute Myocardial Infarction....Pages 243-254 Following Coronary Thrombolysis....Pages 255-263 Arterial Thromboembolism: Valvular Heart Disease and Prosthetic Heart Valves....Pages 265-270 Clinical Trial Dilemmas and Cerebrovascular Disease....Pages 271-277 Atrial Fibrillation and Stroke: The View from Cardiology....Pages 279-282 Atrial Fibrillation and Stroke: The View from Neurology....Pages 283-289 Cardiac Embolic Stroke: Anticoagulating the Elderly....Pages 291-298 Anticoagulants for the Treatment of Transient Ischemic Attacks....Pages 299-315 Epilogue....Pages 317-324 Back Matter....Pages 325-329