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Unfractionated heparin and warfarin have been used effectively for many years to prevent and treat venous thromboembolism, but these agents have significant limitations that affect their clinical utility. New anticoagulant agents, including direct and indirect factor Xa inhibitors and direct thrombin inhibitors, have the potential to transform the management of this common vascular condition. In this Update to the American Journal of Medicine, Sarah Spinler, PharmD, discusses the pharmacology of these new agents and examines evidence from recent clinical trials on their safety and efficacy. |