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Déterminants du risque hémorragique et thrombotique
des anticoagulants oraux et études de bon usage
Johana Bene
To cite this version:
Johana Bene. Déterminants du risque hémorragique et thrombotique des anticoagulants oraux et études de bon usage. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2016. Français. �NNT : 2016LIL2S012�. �tel-01446754�
UNIVERSITE DE LILLE II
Faculté de médecine
Année 2016 N° __________
THESE
POUR L’OBTENTION DU GRADE DE
D
OCTEURde l’U
NIVERSITEde L
ILLEII
Discipline : Pharmacologie
Présentée par
Johana Béné
_________________________
Déterminants du risque hémorragique et thrombotique
des anticoagulants oraux et études de bon usage.
_________________________
Directeur de Thèse : Sophie Gautier Soutenue le 21 septembre 2016
JURY
Maryse Lapeyre Mestre Président
Céline Verstuyft Rapporteur
Antoine Pariente Rapporteur
Sophie Susen Examinateur
Vincent Berezowski Examinateur
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Introduction ... 1
Les antivitamines K, pionniers dans l’anticoagulation par voie
orale ... 4
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Les anticoagulants oraux directs, révolution de l’anticoagulation
orale ... 14
" $ $% " & ! " " $ $% " &# ! " ! # $ % ! $ ! & $ '$ " $ $% " ()Iatrogénie liée aux anticoagulants oraux ... 26
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Critères de choix des anticoagulants oraux ... 38
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Présentation du travail ... 61
Travaux de recherche ... 63
$ * " $ '$ / ! '$ ! '$ 3 / " $ $% #) (" . $ % / % * 0. " % $* % 1* 0 * $ " ! 2 "" 3 #-$ $ " $ $% " 4( " " " ! 4 % % 5 "$ 6% " -4 % % 5 "$ ((Article n°1 ... 142
Article n°2 ... 159
Article n°3 ... 168
Article n°4 ... 179
Discussion ... 198
Conclusion ... 205
Références bibliographiques ... 206
Annexes ... 227
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Tableau 5. Caractéristiques des essais cliniques des différents anticoagulants oraux directs dans la
prévention des AVC et des ES en cas de FANV.
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Tableau 6. Caractéristiques des essais cliniques des différents anticoagulants oraux directs dans la
prévention et le traitement des maladies veineuses thromboemboliques.
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Tableau 7. Médicaments pouvant interagir avec les AVK.
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Tableau 8. Coût des traitements anticoagulants oraux en France.
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Tableau 9. SMR et ASMR des anticoagulants oraux.
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Tableau 11. Valeurs des INR en fonction de la nature de l'AVC.
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