Guidelines of the Spanish Society of Cardiology. Recomendations for the use of antithrombotic therapy in cardiology

The indications for the use of antithrombotic therapy are evolving as new d rugs become available or new indications or dosages are recommended for dru gs already in use. This document reviews and updates the former one published in 1994. To that end, an exhaustive revision of the Literature published in the last 15 yea rs has been undertaken. Following the evidence based medicine dictates, and aiming to select all the relevant publications for each pathology, all stu dies were selected through MEDLINE, using the specified key words for each subject, and were filtered using the following steps: a) only randomized, c ontrolled studies, metaanalysis, guidelines and review articles were chosen ; b) then, the Best-Evidence and Cochrane Collaboration databases were cons ulted; c) finally, the evidence based medicine validation, relevance and ap plicability criteria were assessed for each publication. The use of antiaggregants and anticoagulants are given for the following co nditions: a) prevention of deep vein thrombosis and pulmonary embolism; b) prevention of systemic emboli in patients with lone atrial fibrillation, at rial fibrillation associated or not with rheumatic heart disease, in patien ts with biological or mechanical cardiac valvular prostheses and in dilated cardiomyopathy; c) antithrombotic therapy in coronary heart disease and in coronary intervention; d) the interactions with oral anticoagulants and ho w to control these therapies are also discussed.