{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T01:52:10Z","timestamp":1792288330718,"version":"4.4.0"},"reference-count":130,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:00:00Z","timestamp":1611619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Traditionally, the management of patients with pulmonary embolism has been accomplished with anticoagulant treatment with parenteral heparins and oral vitamin K antagonists. Although the administration of heparins and oral vitamin K antagonists still plays a role in pulmonary embolism management, the use of these therapies are limited due to other options now available. This is due to their toxicity profile, clearance limitations, and many interactions with other medications and nutrients. The emergence of direct oral anticoagulation therapies has led to more options now being available to manage pulmonary embolism in inpatient and outpatient settings conveniently. These oral therapeutic options have opened up opportunities for safe and effective pulmonary embolism management, as more evidence and research is now available about reversal agents and monitoring parameters. The evolution of the pharmacological management of pulmonary embolism has provided us with better understanding regarding the selection of anticoagulants. There is also a better understanding and employment of anticoagulants in pulmonary embolism in special populations, such as patients with liver failure, renal failure, malignancy, and COVID-19.<\/jats:p>","DOI":"10.3390\/medicina57020110","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:03:57Z","timestamp":1611662637000},"page":"110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Review of Medical Therapies for the Management of Pulmonary Embolism"],"prefix":"10.3390","volume":"57","author":[{"given":"Ladan","family":"Panahi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5797-7849","authenticated-orcid":false,"given":"George","family":"Udeani","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horseman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaye","family":"Weston","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nephy","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4190-8800","authenticated-orcid":false,"given":"Merlyn","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mora","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bazan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Texas A&amp;M Rangel College of Pharmacy, 1010 W Ave B, Kingsville, TX 78363, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.mcna.2018.12.013","article-title":"Pulmonary Embolism","volume":"103","author":"Essien","year":"2019","journal-title":"Med. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1164\/ajrccm.164.6.2101045","article-title":"Diagnosis of pulmonary embolism in patients with proximal deep vein thrombosis: Specificity of symptoms and perfusion defects at baseline and during anticoagulant therapy","volume":"164","author":"Girard","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3060","DOI":"10.1016\/S0140-6736(16)30514-1","article-title":"Deep vein thrombosis and pulmonary embolism","volume":"388","year":"2016","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.chest.2015.11.026","article-title":"Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report","volume":"149","author":"Kearon","year":"2016","journal-title":"Chest"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e195S","DOI":"10.1378\/chest.11-2296","article-title":"Prevention of VTE in nonsurgical patients: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Kahn","year":"2012","journal-title":"Chest"},{"key":"ref_6","unstructured":"(2020, October 21). FDA Highlights of Prescribing Information Unfractionated Heparin, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/017029s140lbl.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2519","DOI":"10.1016\/j.jacc.2016.02.073","article-title":"Heparin-Induced Thrombocytopenia: A Comprehensive Clinical Review","volume":"67","author":"Salter","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1182\/bloodadvances.2018024489","article-title":"American Society of Hematology 2018 guidelines for management of venous thromboembolism: Heparin-induced thrombocytopenia","volume":"2","author":"Cuker","year":"2018","journal-title":"Blood Adv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.2146\/ajhp120236","article-title":"ASHP therapeutic position statement on the role of pharmacotherapy in preventing venous thromboembolism in hospitalized patients","volume":"69","author":"Mahan","year":"2012","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e495S","DOI":"10.1378\/chest.11-2303","article-title":"Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Linkins","year":"2012","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"64S","DOI":"10.1378\/chest.119.1_suppl.64S","article-title":"Heparin and low-molecular-weight heparin mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety","volume":"119","author":"Hirsh","year":"2001","journal-title":"Chest"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11239-015-1315-2","article-title":"Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism","volume":"41","author":"Smythe","year":"2016","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1177\/1060028018768449","article-title":"Enoxaparin dosing at extremes of weight: Literature review and dosing recommendations","volume":"52","author":"Sebaaly","year":"2018","journal-title":"Ann. Pharmacother."},{"key":"ref_14","unstructured":"Insert, P. (2020). Fragmin (Dalteparin Sodium), Pharmacia Peapack."},{"key":"ref_15","unstructured":"Squibb, B.-M. (2014). Eliquis (Apixaban) Package Insert, Bristol-Myers Squibb."},{"key":"ref_16","unstructured":"Janssen Pharmaceuticals (2020). Xarelto (Rivaroxaban) Package Insert, Janssen Pharmaceuticals Inc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40262-013-0100-7","article-title":"Clinical pharmacokinetic and pharmacodynamic profile of rivaroxaban","volume":"53","author":"Mueck","year":"2014","journal-title":"Clin. Pharmacokinet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1055\/s-0039-1688501","article-title":"Effects of antibiotic therapy in primary sclerosing cholangitis with and without inflammatory bowel disease: A systematic review and meta-analysis","volume":"39","author":"Shah","year":"2019","journal-title":"Semin. Liver Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s40262-019-00775-z","article-title":"Apixaban: A clinical pharmacokinetic and pharmacodynamic review","volume":"58","author":"Byon","year":"2019","journal-title":"Clin. Pharmacokinet."},{"key":"ref_20","unstructured":"Boehringer Ingelheim Pharmaceuticals (2020). Pradaxa (Dabigatran) Package Insert, Boehringer Ingelheim."},{"key":"ref_21","first-page":"3102","article-title":"How we diagnose and treat deep vein thrombosis","volume":"99","author":"Hirsh","year":"2002","journal-title":"Blood J. Am. Soc. Hematol."},{"key":"ref_22","first-page":"370","article-title":"Pulmonary embolism: Update on management and controversies","volume":"5","author":"Duffett","year":"2020","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1055\/s-0038-1657628","article-title":"Warfarin and heparin-induced skin necrosis and the purple toe syndrome: Infrequent complications of anticoagulant treatment","volume":"78","author":"Sallah","year":"1997","journal-title":"Thromb. Haemost."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7S","DOI":"10.1378\/chest.1412S3","article-title":"Executive summary: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Guyatt","year":"2012","journal-title":"Chest"},{"key":"ref_25","unstructured":"Squibb, B.-M. (2019). Coumadin (Warfarin) Package Insert, Bristol-Myers Squibb."},{"key":"ref_26","unstructured":"Insert MILP (2017). Arixtra (Fondaparinux Sodium) Injection, Mylan Institutional LLC Package."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1124\/dmd.109.029694","article-title":"In vitro assessment of metabolic drug-drug interaction potential of apixaban through cytochrome P450 phenotyping, inhibition, and induction studies","volume":"38","author":"Wang","year":"2010","journal-title":"Drug Metab. Dispos."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMoa1817083","article-title":"Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation","volume":"380","author":"Lopes","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/phar.2298","article-title":"Potential Role of Direct Oral Anticoagulants in the Management of Heparin-induced Thrombocytopenia","volume":"39","author":"Barlow","year":"2019","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1016\/j.jacc.2013.05.083","article-title":"Post-Conditioning the Human Heart: Technical Concerns Beyond the Protocol Algorithm","volume":"62","author":"Liu","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.jjcc.2018.12.018","article-title":"Non-vitamin K antagonist oral anticoagulants with amiodarone, P-glycoprotein inhibitors, or polypharmacy in patients with atrial fibrillation: Systematic review and meta-analysis","volume":"73","author":"Kim","year":"2019","journal-title":"J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1182\/asheducation-2018.1.339","article-title":"Drug-drug interactions in an era of multiple anticoagulants: A focus on clinically relevant drug interactions","volume":"2018","author":"Vazquez","year":"2018","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1124\/dmd.112.050260","article-title":"Characterization of efflux transporters involved in distribution and disposition of apixaban","volume":"41","author":"Zhang","year":"2013","journal-title":"Drug Metab. Dispos."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"By the American Geriatrics Society Beers Criteria Update Expert P (2019). American Geriatrics Society 2019 Updated AGS Beers Criteria(R) for Potentially Inappropriate Medication Use in Older Adults. J. Am. Geriatr. Soc., 67, 674\u2013694.","DOI":"10.1111\/jgs.15767"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1056\/NEJMoa1300615","article-title":"Dabigatran versus warfarin in patients with mechanical heart valves","volume":"369","author":"Eikelboom","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hokusai-VTE Investigators (2013). Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N. Engl. J. Med., 369, 1406\u20131415.","DOI":"10.1056\/NEJMoa1306638"},{"key":"ref_37","unstructured":"Daiichi Sankyo Co. (2015). Savaysa (Edoxaban) [Package Insert], Daiichi Sankyo Co."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40119-016-0058-2","article-title":"Edoxaban: A Comprehensive Review of the Pharmacology and Clinical Data for the Management of Atrial Fibrillation and Venous Thromboembolism","volume":"5","author":"Stacy","year":"2016","journal-title":"Cardiol. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1345\/aph.1Q161","article-title":"Activated partial thromboplastin time versus antifactor Xa heparin assay in monitoring unfractionated heparin by continuous intravenous infusion","volume":"45","author":"Guervil","year":"2011","journal-title":"Ann. Pharmacother."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1592\/phco.19.1.2.30519","article-title":"Problems with monitoring heparin anticoagulation","volume":"19","author":"Bussey","year":"1999","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"108S","DOI":"10.1592\/phco.24.12.108S.36114","article-title":"Challenges in variation and responsiveness of unfractionated heparin","volume":"24","author":"Francis","year":"2004","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S90","DOI":"10.2146\/sp150016","article-title":"Comparison of unfractionated heparin protocols using antifactor Xa monitoring or activated partial thrombin time monitoring","volume":"72","author":"Lee","year":"2015","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"171","DOI":"10.5045\/br.2016.51.3.171","article-title":"Establishing the heparin therapeutic range using aPTT and anti-Xa measurements for monitoring unfractionated heparin therapy","volume":"51","author":"Byun","year":"2016","journal-title":"Blood Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"371","DOI":"10.2146\/ajhp090123","article-title":"Weight-based heparin protocol using antifactor Xa monitoring","volume":"67","author":"Smith","year":"2010","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e152S","DOI":"10.1378\/chest.11-2295","article-title":"Evidence-based management of anticoagulant therapy: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Holbrook","year":"2012","journal-title":"Chest"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1345\/aph.1P088","article-title":"Identifying optimal initial infusion rates for unfractionated heparin in morbidly obese patients","volume":"44","author":"Riney","year":"2010","journal-title":"Ann. Pharmacother."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1002\/j.1875-9114.2011.01049.x","article-title":"Antifactor Xa levels versus activated partial thromboplastin time for monitoring unfractionated heparin","volume":"32","author":"Vandiver","year":"2012","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.thromres.2017.07.006","article-title":"Should we abandon the APTT for monitoring unfractionated heparin?","volume":"157","author":"Arachchillage","year":"2017","journal-title":"Thromb. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jacc.2020.04.053","article-title":"ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Solution Set Oversight Committee","volume":"76","author":"Tomaselli","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"770","DOI":"10.5811\/westjem.2018.5.38235","article-title":"Emergency Reversal of Anticoagulation","volume":"20","author":"Yee","year":"2019","journal-title":"West J. Emerg. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"160S","DOI":"10.1378\/chest.08-0670","article-title":"Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"133","author":"Ansell","year":"2008","journal-title":"Chest"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e44S","DOI":"10.1378\/chest.11-2292","article-title":"Oral anticoagulant therapy: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Ageno","year":"2012","journal-title":"Chest"},{"key":"ref_53","unstructured":"UW Medicine (2020, October 19). Guidelines for Reversal of Anticoagulants. Available online: https:\/\/depts.washington.edu\/anticoag\/home\/sites\/default\/files\/GUIDELINES%20FOR%20REVERSAL%20OF%20ANTICOAGULANTS.pdf."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1177\/1076029613485153","article-title":"Monitoring of unfractionated heparin using activated partial thromboplastin time: An assessment of the current nomogram and analysis according to age","volume":"20","author":"Kim","year":"2014","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_55","unstructured":"(2018). Andexxa (Coagulation Factor Xa (Recombinant), Inactivated-Zhzo): US Prescribing Information, Portola Pharmaceuticals Inc."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Hao, Q., Dong, B.R., Yue, J., Wu, T., and Liu, G.J. (2018). Thrombolytic therapy for pulmonary embolism. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD004437.pub5"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1378\/chest.129.4.1043","article-title":"Management of unsuccessful thrombolysis in acute massive pulmonary embolism","volume":"129","author":"Meneveau","year":"2006","journal-title":"Chest"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1016\/S0002-9149(98)00513-X","article-title":"Comparison of alteplase versus heparin for resolution of major pulmonary embolism","volume":"82","author":"Konstantinides","year":"1998","journal-title":"Am. J. Cardiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"30","DOI":"10.15420\/usc.2016.10.1.30","article-title":"Advanced management options for massive and submassive pulmonary embolism","volume":"10","author":"Malik","year":"2016","journal-title":"US Cardiol. Rev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"I-4","DOI":"10.1161\/01.CIR.0000078468.11849.66","article-title":"The epidemiology of venous thromboembolism","volume":"107","author":"White","year":"2003","journal-title":"Circulation"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1056\/NEJMoa1302097","article-title":"Fibrinolysis for patients with intermediate-risk pulmonary embolism","volume":"370","author":"Meyer","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"A604","DOI":"10.1016\/j.jval.2017.08.1169","article-title":"Efficacy And Safety Outcomes of Recanalization Procedures In Patients with Acute Symptomatic Pulmonary Embolism: Systematic Review And Network Meta-Analysis","volume":"20","author":"Saborido","year":"2017","journal-title":"Value Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1182\/bloodadvances.2020001830","article-title":"American Society of Hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism","volume":"4","author":"Ortel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/1060028015579988","article-title":"Low-dose systemic alteplase (tPA) for the treatment of pulmonary embolism","volume":"49","author":"Brandt","year":"2015","journal-title":"Ann. Pharmacother."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1177\/1060028018811155","article-title":"Assessment of Anticoagulation in Patients Receiving Ultrasound-Assisted Catheter-Directed Thrombolysis for Treatment of Pulmonary Embolism","volume":"53","author":"Edwin","year":"2019","journal-title":"Ann. Pharmacother."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e419S","DOI":"10.1378\/chest.11-2301","article-title":"Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines","volume":"141","author":"Kearon","year":"2012","journal-title":"Chest"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s11239-006-9018-3","article-title":"Tenecteplase to treat pulmonary embolism in the emergency department","volume":"23","author":"Kline","year":"2007","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_69","first-page":"1035","article-title":"Use of oral anticoagulants in obese patients","volume":"2","author":"Graves","year":"2017","journal-title":"JSM Atheroscler."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1177\/0091270006292127","article-title":"Safety, tolerability, pharmacodynamics, and pharmacokinetics of rivaroxaban\u2014An oral, direct factor Xa inhibitor\u2014Are not affected by aspirin","volume":"46","author":"Kubitza","year":"2006","journal-title":"J. Clin. Pharmacol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/FTD.0000000000000463","article-title":"Comparison of antifactor Xa and activated partial thromboplastin time monitoring for heparin dosing in vascular surgery patients: A single-center retrospective study","volume":"40","author":"Rizk","year":"2018","journal-title":"Ther. Drug Monit."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1097\/FPC.0b013e32833433b6","article-title":"VKORC1 pharmacogenomics summary","volume":"20","author":"Owen","year":"2010","journal-title":"Pharm. Genom."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"Connolly","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1056\/NEJMoa0906598","article-title":"Dabigatran versus warfarin in the treatment of acute venous thromboembolism","volume":"361","author":"Schulman","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2440","DOI":"10.1056\/NEJMc1215900","article-title":"Ischemic stroke in an obese patient receiving dabigatran","volume":"368","author":"Breuer","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1159\/000445328","article-title":"Pharmacokinetics, Pharmacodynamics, and Safety of Single-Dose Rivaroxaban in Chronic Hemodialysis","volume":"43","author":"Dias","year":"2016","journal-title":"Am. J. Nephrol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2165\/11595320-000000000-00000","article-title":"Rivaroxaban: Population pharmacokinetic analyses in patients treated for acute deep-vein thrombosis and exposure simulations in patients with atrial fibrillation treated for stroke prevention","volume":"50","author":"Mueck","year":"2011","journal-title":"Clin. Pharmacokinet."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/bcp.12114","article-title":"Effect of extremes of body weight on the pharmacokinetics, pharmacodynamics, safety and tolerability of apixaban in healthy subjects","volume":"76","author":"Upreti","year":"2013","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1016\/j.jacc.2006.12.049","article-title":"The impact of renal dysfunction on outcomes in the ExTRACT-TIMI 25 trial","volume":"49","author":"Fox","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1056\/NEJMoa1107039","article-title":"Apixaban versus warfarin in patients with atrial fibrillation","volume":"365","author":"Granger","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/ajg.2008.34","article-title":"Risk of venous thromboembolism in patients with liver disease: A nationwide population-based case-control study","volume":"104","author":"Sogaard","year":"2009","journal-title":"Am. J. Gastroenterol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s11739-014-1163-7","article-title":"Epidemiology of venous thromboembolism in patients with liver diseases: A systematic review and meta-analysis","volume":"10","author":"Qi","year":"2015","journal-title":"Intern. Emerg. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/1358863X19875813","article-title":"Unfractionated heparin infusion for treatment of venous thromboembolism based on actual body weight without dose capping","volume":"25","author":"Shlensky","year":"2020","journal-title":"Vasc. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1182\/bloodadvances.2018024893","article-title":"American Society of Hematology 2018 guidelines for management of venous thromboembolism: Optimal management of anticoagulation therapy","volume":"2","author":"Witt","year":"2018","journal-title":"Blood Adv."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"278","DOI":"10.2215\/CJN.02170218","article-title":"Clinical Pharmacology of Oral Anticoagulants in Patients with Kidney Disease","volume":"14","author":"Jain","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1177\/0091270011409231","article-title":"Renal profiles of anticoagulants","volume":"52","author":"Harder","year":"2012","journal-title":"J. Clin. Pharmacol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1681\/ASN.2008070802","article-title":"Kidney function influences warfarin responsiveness and hemorrhagic complications","volume":"20","author":"Limdi","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1053\/j.ajkd.2010.05.023","article-title":"Warfarin dosing in patients with impaired kidney function","volume":"56","author":"Limdi","year":"2010","journal-title":"Am. J. Kidney Dis."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Ella, I., and Tapson, V.F. (2020). Advances in the diagnosis of acute pulmonary embolism. F1000Research, 9.","DOI":"10.12688\/f1000research.21347.1"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e202175","DOI":"10.1001\/jamanetworkopen.2020.2175","article-title":"Association Between Use of Warfarin for Atrial Fibrillation and Outcomes Among Patients With End-Stage Renal Disease: A Systematic Review and Meta-analysis","volume":"3","author":"Randhawa","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2165\/11318170-000000000-00000","article-title":"Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: An open-label, parallel-group, single-centre study","volume":"49","author":"Stangier","year":"2010","journal-title":"Clin. Pharmacokinet."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1253\/circj.CJ-12-0454","article-title":"Rivaroxaban vs. warfarin in Japanese patients with atrial fibrillation\u2014The J-ROCKET AF study","volume":"76","author":"Hori","year":"2012","journal-title":"Circ. J."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1111\/j.1365-2125.2010.03753.x","article-title":"Effects of renal impairment on the pharmacokinetics, pharmacodynamics and safety of rivaroxaban, an oral, direct Factor Xa inhibitor","volume":"70","author":"Kubitza","year":"2010","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/jcph.633","article-title":"Effect of renal impairment on the pharmacokinetics, pharmacodynamics, and safety of apixaban","volume":"56","author":"Chang","year":"2016","journal-title":"J. Clin. Pharmacol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1160\/TH14-06-0547","article-title":"Pharmacokinetics, safety, and tolerability of edoxaban in end-stage renal disease subjects undergoing haemodialysis","volume":"113","author":"Parasrampuria","year":"2015","journal-title":"Thromb. Haemost."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1056\/NEJMoa1711948","article-title":"Edoxaban for the treatment of cancer-associated venous thromboembolism","volume":"378","author":"Raskob","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Young, A.M., Marshall, A., Thirlwall, J., Chapman, O., Lokare, A., Hill, C., Hale, D., Dunn, J.A., Lyman, G.H., and Hutchinson, C. (2018). Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: Results of a randomized trial (SELECT-D). J. Clin. Oncol.","DOI":"10.1200\/JCO.2018.78.8034"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the treatment of venous thromboembolism associated with cancer","volume":"382","author":"Agnelli","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"3317","DOI":"10.1182\/bloodadvances.2018024828","article-title":"American Society of Hematology 2018 guidelines for management of venous thromboembolism: Venous thromboembolism in the context of pregnancy","volume":"2","author":"Lim","year":"2018","journal-title":"Blood Adv."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1046\/j.0306-5251.2001.01517.x","article-title":"Excretion of low molecular weight heparin in human milk","volume":"52","author":"Richter","year":"2001","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3389\/fphar.2014.00065","article-title":"Physiologic and pharmacokinetic changes in pregnancy","volume":"5","author":"Costantine","year":"2014","journal-title":"Front. Pharmacol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Pariente, G., Leibson, T., Carls, A., Adams-Webber, T., Ito, S., and Koren, G. (2016). Pregnancy-associated changes in pharmacokinetics: A systematic review. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002160"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1111\/j.1471-0528.1973.tb16051.x","article-title":"Induction of hepatic enzymes during normal human pregnancy","volume":"80","author":"Davis","year":"1973","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1097\/EJA.0b013e32833f6f6f","article-title":"Regional anaesthesia and antithrombotic agents: Recommendations of the European Society of Anaesthesiology","volume":"27","author":"Gogarten","year":"2010","journal-title":"Eur. J. Anaesthesiol. EJA"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/01.aoa.0000552901.03545.fb","article-title":"Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines","volume":"39","author":"Horlocker","year":"2019","journal-title":"Obstet. Anesth. Digest."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.thromres.2018.07.022","article-title":"Efficacy and safety of direct oral anticoagulants during pregnancy; a systematic literature review","volume":"169","author":"Lameijer","year":"2018","journal-title":"Thromb. Res."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ajog.2015.06.065","article-title":"Rivaroxaban transfer across the dually perfused isolated human placental cotyledon","volume":"213","author":"Bapat","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.ejim.2014.03.009","article-title":"Diagnosis and management of pulmonary embolism in the elderly","volume":"25","author":"Righini","year":"2014","journal-title":"Eur. J. Intern. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1001\/archinte.158.6.585","article-title":"Trends in the incidence of deep vein thrombosis and pulmonary embolism: A 25-year population-based study","volume":"158","author":"Silverstein","year":"1998","journal-title":"Arch. Intern. Med."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1001\/archinte.1991.00400050081016","article-title":"A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: The Worcester DVT Study","volume":"151","author":"Anderson","year":"1991","journal-title":"Arch. Intern. Med."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1016\/S0140-6736(98)07534-5","article-title":"Acute pulmonary embolism: Clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER)","volume":"353","author":"Goldhaber","year":"1999","journal-title":"Lancet"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.amjmed.2012.12.007","article-title":"Treatment of unstable pulmonary embolism in the elderly and those with comorbid conditions","volume":"126","author":"Stein","year":"2013","journal-title":"Am. J. Med."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.revmed.2013.07.004","article-title":"Clinical features of pulmonary embolism in elderly: A comparative study of 64 patients","volume":"35","author":"Tisserand","year":"2014","journal-title":"Rev. Med. Interne"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afg098","article-title":"Pulmonary embolism: Differences in presentation between older and younger patients","volume":"32","author":"Timmons","year":"2003","journal-title":"Age Ageing"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1253\/circj.69.981","article-title":"Differences in clinical presentation of pulmonary embolism in older vs younger patients","volume":"69","author":"Kokturk","year":"2005","journal-title":"Circ. J."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/jama.2018.14346","article-title":"Venous thromboembolism: Advances in diagnosis and treatment","volume":"320","author":"Tritschler","year":"2018","journal-title":"JAMA"},{"key":"ref_117","first-page":"e1","article-title":"Hematological findings and complications of COVID-19","volume":"213","author":"Terpos","year":"2020","journal-title":"Am. J. Hematol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1155\/2012\/175849","article-title":"Venous thromboembolism in cirrhosis: A review of the literature","volume":"26","author":"Buresi","year":"2012","journal-title":"Can. J. Gastroenterol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1111\/bjh.12593","article-title":"Routine coagulation assays underestimate levels of antithrombin-dependent drugs but not of direct anticoagulant drugs in plasma from patients with cirrhosis","volume":"163","author":"Potze","year":"2013","journal-title":"Br. J. Haematol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1378\/chest.108.5.1303","article-title":"Inflammatory cytokines in the BAL of patients with ARDS: Persistent elevation over time predicts poor outcome","volume":"108","author":"Meduri","year":"1995","journal-title":"Chest"},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Henderson, L.A., Canna, S.W., Schulert, G.S., Volpi, S., Lee, P.Y., Kernan, K.F., Caricchio, R., Mahmud, S., Hazen, M.M., and Halyabar, O. (2020). On the alert for cytokine storm: Immunopathology in COVID-19. Arthritis Rheumatol.","DOI":"10.1002\/art.41285"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/thoraxjnl-2013-204367","article-title":"Proteinase-activated receptors in fibroproliferative lung disease","volume":"69","author":"Williams","year":"2014","journal-title":"Thorax"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/j.jacc.2018.03.023","article-title":"Oral anticoagulation in patients with liver disease","volume":"71","author":"Qamar","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/ejh.12844","article-title":"The efficacy and safety of direct oral anticoagulants vs traditional anticoagulants in cirrhosis","volume":"98","author":"Hum","year":"2017","journal-title":"Eur. J. Haematol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1200\/JCO.2009.22.4584","article-title":"Impact of venous thromboembolism and anticoagulation on cancer and cancer survival","volume":"27","author":"Kuderer","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/j.1538-7836.2007.02374.x","article-title":"Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy","volume":"5","author":"Khorana","year":"2007","journal-title":"J. Thromb. Haemost."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1200\/JCO.2014.59.7351","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update 2014","volume":"33","author":"Lyman","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jama.2015.9243","article-title":"Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: A randomized clinical trial","volume":"314","author":"Lee","year":"2015","journal-title":"JAMA"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1056\/NEJMoa025313","article-title":"Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer","volume":"349","author":"Lee","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"2950","DOI":"10.1016\/j.jacc.2020.04.031","article-title":"COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review","volume":"75","author":"Bikdeli","year":"2020","journal-title":"J. Am. Coll. 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