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Argatroban represents the first clinically approved antithrombin agent, which was made available in Japan several years ago. Two recombinant hirudin preparations, Revasc (Novartis) and Refludan (Aventis), are available for postsurgical DVT prophylaxis and alternate anticoagulant use in patients with heparin-induced thrombocytopenia. A synthetic antithrombin agent based on the combined structures of hirudin and antithrombin peptides, hirulog (Bivalirudin), is undergoing clinical trials in cardiovascular indications. Additional studies on the hirudins are being carried out to test their efficacy as surgical and interventional anticoagulants as replacements for heparin. However, the need for a proper antagonist is one of the limiting factors for the optimal development of hirudin in this indication. Several of the synthetic thrombin inhibitors are also being developed for oral use for the prophylaxis of DVT in surgical patients. Since the therapeutic index of thrombin inhibitors is narrower than that of heparin, this route may not be an optimal approach for the development of these agents. Despite several unresolved developmental issues, the thrombin inhibitors provide a useful alternative to heparin anticoagulation and may prove to be useful in validated clinical use.<\/jats:p>","DOI":"10.1177\/10760296990050s109","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T10:12:19Z","timestamp":1500545539000},"page":"S45-S55","source":"Crossref","is-referenced-by-count":9,"title":["Antithrombin Agents: The New Class of Anticoagulant and Antithrombotic Drugs"],"prefix":"10.1177","volume":"5","author":[{"given":"Jawed","family":"Fareed","sequence":"first","affiliation":[{"name":"Hemostasis and Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, Illinois, and University of Texas Southwestern Medical Center and Dallas Thrombosis Hemostasis Clinical Center, Dallas, Texas, U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce 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