Novel Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation
Atrial fibrillation (AF) is the most common cardiac arrhythmia that can potentially result in stroke. Vitamin K antagonists (VKA) like warfarin were for many decades the only oral anticoagulants available for stroke prevention in patients with non-valvular atrial fibrillation (AF) at high risk of st...
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| Veröffentlicht in: | Cardiovascular drugs and therapy 2014-06, Vol.28 (3), p.247-262 |
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| creator | Jalota, A. Scarabelli, T. M. Saravolatz, L. Bakhsh, M. U. Agrawal, P. Jalota, R. Chen-Scarabelli, C. Fuster, V. Halperin, J. |
| description | Atrial fibrillation (AF) is the most common cardiac arrhythmia that can potentially result in stroke. Vitamin K antagonists (VKA) like warfarin were for many decades the only oral anticoagulants available for stroke prevention in patients with non-valvular atrial fibrillation (AF) at high risk of stroke. Recently, new oral anticoagulants (NOACS) have been introduced that act via direct inhibition of thrombin (dabigatran) or activated factor X (edoxaban, rivaroxaban and apixaban). Unlike VKAs, these anticoagulants do not require routine INR monitoring and posses favorable pharmacological properties. NOACs act rapidly, and have a stable and predictable dose-related anticoagulant effect with few clinically relevant drug-drug interactions. Phase III trials comparing these agents to warfarin for stroke prevention in patients with non-valvular AF demonstrated that they are at least as efficacious and safe as warfarin. Evolution of clinical guidelines to incorporate the new anticoagulants for stroke prevention in non-valvular AF may result in a reduction in the incidence of AF-related strokes. Safe and effective use of these new drugs in clinical practice requires understanding of their distinct pharmacological properties. |
| doi_str_mv | 10.1007/s10557-014-6524-y |
| format | Article |
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M. ; Saravolatz, L. ; Bakhsh, M. U. ; Agrawal, P. ; Jalota, R. ; Chen-Scarabelli, C. ; Fuster, V. ; Halperin, J.</creator><creatorcontrib>Jalota, A. ; Scarabelli, T. M. ; Saravolatz, L. ; Bakhsh, M. U. ; Agrawal, P. ; Jalota, R. ; Chen-Scarabelli, C. ; Fuster, V. ; Halperin, J.</creatorcontrib><description>Atrial fibrillation (AF) is the most common cardiac arrhythmia that can potentially result in stroke. Vitamin K antagonists (VKA) like warfarin were for many decades the only oral anticoagulants available for stroke prevention in patients with non-valvular atrial fibrillation (AF) at high risk of stroke. Recently, new oral anticoagulants (NOACS) have been introduced that act via direct inhibition of thrombin (dabigatran) or activated factor X (edoxaban, rivaroxaban and apixaban). Unlike VKAs, these anticoagulants do not require routine INR monitoring and posses favorable pharmacological properties. NOACs act rapidly, and have a stable and predictable dose-related anticoagulant effect with few clinically relevant drug-drug interactions. Phase III trials comparing these agents to warfarin for stroke prevention in patients with non-valvular AF demonstrated that they are at least as efficacious and safe as warfarin. Evolution of clinical guidelines to incorporate the new anticoagulants for stroke prevention in non-valvular AF may result in a reduction in the incidence of AF-related strokes. Safe and effective use of these new drugs in clinical practice requires understanding of their distinct pharmacological properties.</description><identifier>ISSN: 0920-3206</identifier><identifier>EISSN: 1573-7241</identifier><identifier>DOI: 10.1007/s10557-014-6524-y</identifier><identifier>PMID: 24842559</identifier><identifier>CODEN: CDTHET</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Anticoagulants - adverse effects ; Anticoagulants - pharmacology ; Anticoagulants - therapeutic use ; Antithrombins - adverse effects ; Antithrombins - therapeutic use ; Atrial Fibrillation - complications ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - physiopathology ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiovascular system ; Drug Monitoring - methods ; Factor Xa Inhibitors - adverse effects ; Factor Xa Inhibitors - therapeutic use ; Heart ; Humans ; International Normalized Ratio ; Medical sciences ; Medicine ; Medicine & Public Health ; Neurology ; Pharmacology. Drug treatments ; Practice Guidelines as Topic ; Review Article ; Stroke - etiology ; Stroke - prevention & control ; Vascular diseases and vascular malformations of the nervous system ; Warfarin - adverse effects ; Warfarin - therapeutic use</subject><ispartof>Cardiovascular drugs and therapy, 2014-06, Vol.28 (3), p.247-262</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-794cc9a3e9934e91eb2a4ee6c8c0858e6a020345a509890401f14f72301cda63</citedby><cites>FETCH-LOGICAL-c435t-794cc9a3e9934e91eb2a4ee6c8c0858e6a020345a509890401f14f72301cda63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10557-014-6524-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10557-014-6524-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28640858$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24842559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jalota, A.</creatorcontrib><creatorcontrib>Scarabelli, T. M.</creatorcontrib><creatorcontrib>Saravolatz, L.</creatorcontrib><creatorcontrib>Bakhsh, M. U.</creatorcontrib><creatorcontrib>Agrawal, P.</creatorcontrib><creatorcontrib>Jalota, R.</creatorcontrib><creatorcontrib>Chen-Scarabelli, C.</creatorcontrib><creatorcontrib>Fuster, V.</creatorcontrib><creatorcontrib>Halperin, J.</creatorcontrib><title>Novel Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation</title><title>Cardiovascular drugs and therapy</title><addtitle>Cardiovasc Drugs Ther</addtitle><addtitle>Cardiovasc Drugs Ther</addtitle><description>Atrial fibrillation (AF) is the most common cardiac arrhythmia that can potentially result in stroke. Vitamin K antagonists (VKA) like warfarin were for many decades the only oral anticoagulants available for stroke prevention in patients with non-valvular atrial fibrillation (AF) at high risk of stroke. Recently, new oral anticoagulants (NOACS) have been introduced that act via direct inhibition of thrombin (dabigatran) or activated factor X (edoxaban, rivaroxaban and apixaban). Unlike VKAs, these anticoagulants do not require routine INR monitoring and posses favorable pharmacological properties. NOACs act rapidly, and have a stable and predictable dose-related anticoagulant effect with few clinically relevant drug-drug interactions. Phase III trials comparing these agents to warfarin for stroke prevention in patients with non-valvular AF demonstrated that they are at least as efficacious and safe as warfarin. Evolution of clinical guidelines to incorporate the new anticoagulants for stroke prevention in non-valvular AF may result in a reduction in the incidence of AF-related strokes. Safe and effective use of these new drugs in clinical practice requires understanding of their distinct pharmacological properties.</description><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - pharmacology</subject><subject>Anticoagulants - therapeutic use</subject><subject>Antithrombins - adverse effects</subject><subject>Antithrombins - therapeutic use</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Drug Monitoring - methods</subject><subject>Factor Xa Inhibitors - adverse effects</subject><subject>Factor Xa Inhibitors - therapeutic use</subject><subject>Heart</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Pharmacology. Drug treatments</subject><subject>Practice Guidelines as Topic</subject><subject>Review Article</subject><subject>Stroke - etiology</subject><subject>Stroke - prevention & control</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>Warfarin - adverse effects</subject><subject>Warfarin - therapeutic use</subject><issn>0920-3206</issn><issn>1573-7241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp10EtLxDAQB_Agiq6PD-BFCiJ4qU5ebXNcxBeILrj3kI1TjXYbTVplv70puz4QPOUwv5nM_AnZp3BCAcrTSEHKMgcq8kIykS_WyIjKkuclE3SdjEAxyDmDYotsx_gMqUepapNsMVEJJqUakbtb_45NNm47Z7157BvTdjGrfcjuu-BfMJsEfMdU9W3m2mxiOoeD-HDdUzbugjNNduFmwTWNGdAu2ahNE3Fv9e6Q6cX59Owqv7m7vD4b3-RWcNnlpRLWKsNRKS5QUZwxIxALW1moZIWFAQZcSCNBVQoE0JqKumQcqH0wBd8hx8uxr8G_9Rg7PXfRYlqiRd9HTaVgAKrgVaKHf-iz70OblhsUpRxKWiZFl8oGH2PAWr8GNzdhoSnoIWy9DFunsPUQtl6knoPV5H42x4fvjq90EzhaAROtaepgWuvij6sKMVybHFu6mErtI4ZfK_77-ydhTpYO</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Jalota, A.</creator><creator>Scarabelli, T. 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Vascular system</topic><topic>Cardiovascular system</topic><topic>Drug Monitoring - methods</topic><topic>Factor Xa Inhibitors - adverse effects</topic><topic>Factor Xa Inhibitors - therapeutic use</topic><topic>Heart</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Pharmacology. Drug treatments</topic><topic>Practice Guidelines as Topic</topic><topic>Review Article</topic><topic>Stroke - etiology</topic><topic>Stroke - prevention & control</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>Warfarin - adverse effects</topic><topic>Warfarin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jalota, A.</creatorcontrib><creatorcontrib>Scarabelli, T. 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M.</au><au>Saravolatz, L.</au><au>Bakhsh, M. U.</au><au>Agrawal, P.</au><au>Jalota, R.</au><au>Chen-Scarabelli, C.</au><au>Fuster, V.</au><au>Halperin, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation</atitle><jtitle>Cardiovascular drugs and therapy</jtitle><stitle>Cardiovasc Drugs Ther</stitle><addtitle>Cardiovasc Drugs Ther</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>28</volume><issue>3</issue><spage>247</spage><epage>262</epage><pages>247-262</pages><issn>0920-3206</issn><eissn>1573-7241</eissn><coden>CDTHET</coden><abstract>Atrial fibrillation (AF) is the most common cardiac arrhythmia that can potentially result in stroke. Vitamin K antagonists (VKA) like warfarin were for many decades the only oral anticoagulants available for stroke prevention in patients with non-valvular atrial fibrillation (AF) at high risk of stroke. Recently, new oral anticoagulants (NOACS) have been introduced that act via direct inhibition of thrombin (dabigatran) or activated factor X (edoxaban, rivaroxaban and apixaban). Unlike VKAs, these anticoagulants do not require routine INR monitoring and posses favorable pharmacological properties. NOACs act rapidly, and have a stable and predictable dose-related anticoagulant effect with few clinically relevant drug-drug interactions. Phase III trials comparing these agents to warfarin for stroke prevention in patients with non-valvular AF demonstrated that they are at least as efficacious and safe as warfarin. Evolution of clinical guidelines to incorporate the new anticoagulants for stroke prevention in non-valvular AF may result in a reduction in the incidence of AF-related strokes. Safe and effective use of these new drugs in clinical practice requires understanding of their distinct pharmacological properties.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24842559</pmid><doi>10.1007/s10557-014-6524-y</doi><tpages>16</tpages></addata></record> |
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| subjects | Anticoagulants - adverse effects Anticoagulants - pharmacology Anticoagulants - therapeutic use Antithrombins - adverse effects Antithrombins - therapeutic use Atrial Fibrillation - complications Atrial Fibrillation - drug therapy Atrial Fibrillation - physiopathology Biological and medical sciences Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiovascular system Drug Monitoring - methods Factor Xa Inhibitors - adverse effects Factor Xa Inhibitors - therapeutic use Heart Humans International Normalized Ratio Medical sciences Medicine Medicine & Public Health Neurology Pharmacology. Drug treatments Practice Guidelines as Topic Review Article Stroke - etiology Stroke - prevention & control Vascular diseases and vascular malformations of the nervous system Warfarin - adverse effects Warfarin - therapeutic use |
| title | Novel Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation |
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