The english version of the website of the School of Medicine is under development

Δημοσίευση

Direct Oral Anticoagulants in Nonvalvular Atrial Fibrillation: Practical Considerations on the Choice of Agent and Dosing.

TitleDirect Oral Anticoagulants in Nonvalvular Atrial Fibrillation: Practical Considerations on the Choice of Agent and Dosing.
Publication TypeJournal Article
Year of Publication2018
AuthorsFarmakis, D., Davlouros P., Giamouzis G., Giannakoulas G., Pipilis A., Tsivgoulis G., & Parissis J.
JournalCardiology
Volume140
Issue2
Pagination126-132
Date Published2018
ISSN1421-9751
KeywordsAdministration, Oral, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Decision Making, Embolism, Female, Humans, Male, Randomized Controlled Trials as Topic, Risk Factors, Stroke
Abstract

Direct or new oral anticoagulants (NOACs), including the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, have recently revolutionized the field of antithrombotic therapy for stroke and systemic embolism prevention in nonvalvular atrial fibrillation (NVAF). Randomized controlled trials have shown that these agents have at least comparable efficacy with vitamin K antagonists along with superior safety, at least in what concerns intracranial hemorrhage. As a result, NOACs are indicated as first-line anticoagulation therapy for NVAF patients with at least one risk factor for stroke or systemic embolism. The rapid introduction, however, of NOACs in a field dominated for decades by vitamin antagonists and the variety of agents and dosing schemes may create difficulties in decision making. In the present article, we attempt to determine a practical approach to the choice of agent and dose in different clinical scenarios by considering not only the results of seminal randomized trials and post hoc analyses but also data from real-world patient populations as well as the recently available possibility of rapid NOAC reversal.

DOI10.1159/000489922
Alternate JournalCardiology
PubMed ID29975925

Contact

Secretariat of the School of Medicine
 

Connect

School of Medicine's presence in social networks
Follow Us or Connect with us.