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Warfarin faring better: Vitamin K antagonists beat rivaroxaban and apixaban in the INVICTUS and PROACT Xa trials
J Thromb Haemost. 2023 Jul 8:S1538-7836(23)00523-8. doi: 10.1016/j.jtha.2023.06.036. Online ahead of print.ABSTRACTAlthough guidelines give preference to the direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs) for stroke prevention in most patients with atrial fibrillation (AF), DOACs are not recommended in those with rheumatic heart disease or mechanical heart valves. The results of the INVICTUS trial (Investigation of Rheumatic AF Treatment Using Vitamin K Antagonists, Rivaroxaban or Aspirin Studies), which compared rivaroxaban with a VKA in patients with rheumatic heart disease associated AF, and the PR...
Source: Thrombosis and Haemostasis - July 10, 2023 Category: Hematology Authors: John W Eikelboom Jeffrey I Weitz Source Type: research

The Non-Vitamin K Antagonist Oral Anticoagulants in Heart Disease: Section V-Special Situations.
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 coagu...
Source: Thrombosis and Haemostasis - January 1, 2019 Category: Hematology Authors: De Caterina R, Ageno W, Agnelli G, Chan NC, Diener HC, Hylek E, Raskob GE, Siegal DM, Verheugt FWA, Lip GYH, Weitz JI Tags: Thromb Haemost Source Type: research

Vitamin K antagonists in heart disease: Current status and perspectives (Section III). Position Paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease.
Abstract Oral anticoagulants are a mainstay of cardiovascular therapy, and for over 60 years vitamin K antagonists (VKAs) were the only available agents for long-term use. VKAs interfere with the cyclic inter-conversion of vitamin K and its 2,3 epoxide, thus inhibiting γ-carboxylation of glutamate residues at the amino-termini of vitamin K-dependent proteins, including the coagulation factors (F) II (prothrombin), VII, IX and X, as well as of the anticoagulant proteins C, S and Z. The overall effect of such interference is a dose-dependent anticoagulant effect, which has been therapeutically exploited in heart di...
Source: Thrombosis and Haemostasis - November 14, 2013 Category: Hematology Authors: De Caterina R, Husted S, Wallentin L, Andreotti F, Arnesen H, Bachmann F, Baigent C, Huber K, Jespersen J, Kristensen SD, Lip GY, Morais J, Rasmussen LH, Siegbahn A, Verheugt FW, Weitz JI Tags: Thromb Haemost Source Type: research