American Society of Hirudotherapy

Oral anticoagulation in primary care

Research article published in Revista espanola de sanidad penitenciaria (2017)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentAltirriba et al. · Revista espanola de sanidad penitenciaria, 2017

Abstract

Oral anticoagulant therapy is currently widespread in the population and primary care plays an important role in its control in Spain. Younger populations, such as those in prisons, often require this treatment for reasons other than atrial fibrillation, often in relation to valvular or congenital or acquired hypercoagulability situations. The possibility of obtaining the INR by portable coagulometers has allowed primary care physicians to tackle the indication of this therapy and the control of these patients in coordination with haematology services. The emergence of new therapeutic alternatives (Dabigatran, Rivaroxaban, Apixaban and Edoxaban, the so called "ACOD") has permitted the expansion of options for oral anticoagulation in some cases, since they do not require systematic monitoring of their effect and interact with far fewer drugs than their predecessors, although there are still restrictions by the health authorities on their widespread use. This article reviews the different indications of oral anticoagulant therapy according to the new recommendations as well as the clinical scenarios in which it should be used.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAdministration, OralAmbulatory CareAnticoagulantsAtrial FibrillationContraindications, DrugDrug MonitoringHeart Valve DiseasesHumansPrimary Health CareSpainStrokeThromboembolism

Summary

Peer-reviewed research on anticoagulant and antithrombotic agents relevant to leech-derived compounds and thrombosis management. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This article reviews the indications for oral anticoagulant therapy in primary care, contrasting traditional vitamin-K antagonists with newer direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, edoxaban) that the authors note require no routine INR monitoring and interact with fewer drugs. For ASH it provides clinical-context background: it maps the modern antithrombotic landscape and the management settings (atrial fibrillation, valvular and hypercoagulable states) into which any leech-derived anticoagulant candidate would have to fit, and it underscores why bleeding/monitoring trade-offs drive drug selection. Caveat: this is a narrative review of prescribing practice, not original data and not a study of hirudotherapy or leech-derived compounds; it neither tests nor mentions medicinal-leech therapy, so its value here is purely as orienting context on the anticoagulant field.

Citation

Oral anticoagulation in primary care.

Altirriba et al. · Revista espanola de sanidad penitenciaria, 2017

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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