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Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation.

Publication ,  Journal Article
Fanaroff, AC; Ohman, EM
Published in: Annu Rev Med
January 27, 2019

Atrial fibrillation (AF) increases a patient's stroke risk four- to five-fold. Anticoagulation with the vitamin K antagonist (VKA) warfarin reduces the risk of stroke by 67%, but warfarin carries a significant risk of major bleeding and has unpredictable pharmacodynamics with a narrow therapeutic window, necessitating frequent monitoring of its anticoagulant effect. The non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban provide more predictable anticoagulant activity than warfarin with a lower risk of major bleeding, and each is noninferior to warfarin for the prevention of stroke. All have earned regulatory approval in the past eight years. At least one of the NOACs is approved for use in all patients with AF, except those with mechanical valves and rheumatic mitral valve disease, for whom warfarin remains the only option. Recent clinical trials have shown that antithrombotic regimens including NOACs are safe and effective in patients with AF who need potent antiplatelet therapy.

Duke Scholars

Published In

Annu Rev Med

DOI

EISSN

1545-326X

Publication Date

January 27, 2019

Volume

70

Start / End Page

61 / 75

Location

United States

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Survival Rate
  • Stroke
  • Rivaroxaban
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Pyridones
  • Pyrazoles
  • Prognosis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fanaroff, A. C., & Ohman, E. M. (2019). Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation. Annu Rev Med, 70, 61–75. https://doi.org/10.1146/annurev-med-042617-092334
Fanaroff, Alexander C., and E Magnus Ohman. “Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation.Annu Rev Med 70 (January 27, 2019): 61–75. https://doi.org/10.1146/annurev-med-042617-092334.
Fanaroff AC, Ohman EM. Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation. Annu Rev Med. 2019 Jan 27;70:61–75.
Fanaroff, Alexander C., and E. Magnus Ohman. “Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation.Annu Rev Med, vol. 70, Jan. 2019, pp. 61–75. Pubmed, doi:10.1146/annurev-med-042617-092334.
Fanaroff AC, Ohman EM. Non-Vitamin K Antagonist Oral Anticoagulants in the Treatment of Atrial Fibrillation. Annu Rev Med. 2019 Jan 27;70:61–75.

Published In

Annu Rev Med

DOI

EISSN

1545-326X

Publication Date

January 27, 2019

Volume

70

Start / End Page

61 / 75

Location

United States

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Survival Rate
  • Stroke
  • Rivaroxaban
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Pyridones
  • Pyrazoles
  • Prognosis