The Non-Vitamin K Antagonist Oral Anticoagulants in Heart Disease: Section V-Special Situations.

The Non-Vitamin K Antagonist Oral Anticoagulants in Heart Disease: Section V-Special Situations. Thromb Haemost. 2019 Jan;119(1):14-38 Authors: De Caterina R, Ageno W, Agnelli G, Chan NC, Diener HC, Hylek E, Raskob GE, Siegal DM, Verheugt FWA, Lip GYH, Weitz JI Abstract Non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban and rivaroxaban, which inhibit factor Xa. In large clinical trials comparing the NOACs with the vitamin K antagonist (VKA) warfarin, dabigatran, apixaban, rivaroxaban and edoxaban were at least as effective for stroke prevention in atrial fibrillation and for treatment of venous thromboembolism, but were associated with less intracranial bleeding. In addition, the NOACs are more convenient to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring. Consequently, the NOACs are now replacing VKAs for these indications, and their use is increasing. Although, as a class, the NOACs have a favourable benefit-risk profile compared with VKAs, choosing among them is complicated because they have not been compared in head-to-head trials. Therefore, selection depends on the results of the individual trials, renal function, the potential for drug-drug interactions and preference for once- or twice-daily dosing. In addition, several 'special situations' were not adequately studied in the dedicated clinical...
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research