Novel oral anticoagulants in gastroenterology practice

Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is associated with a 5-fold increase in the risk of ischemic stroke, and AF-related strokes have worse outcomes than those not associated with AF. Warfarin reduces the risk of stroke in patients with AF by approximately two-thirds and is more effective than aspirin or dual antiplatelet therapy with aspirin and clopidogrel. Although effective, warfarin has limitations that complicate its use. These include unpredictable pharmacokinetics and pharmacodynamics related to genetic polymorphisms and to variations in dietary vitamin K intake and numerous drug-drug interactions. Therefore, frequent monitoring is needed to attempt to keep the international normalized ratio (INR) within the therapeutic range. Such monitoring is inconvenient for patients and physicians and costly for the healthcare system. The limitations of warfarin contribute to its underuse in eligible patients with AF, and even when warfarin is given, the INR is frequently outside the therapeutic range.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Review Articles Source Type: research