A guidance pathway for the selection of novel anticoagulants in the treatment of atrial fibrillation.
Oral anticoagulation with vitamin K antagonists has served as the primary treatment for the prevention of stroke and systemic embolization in patients with atrial fibrillation (AF) for decades. Over the past several years, multiple novel oral anticoagulants targeting key mediators of coagulation, including thrombin and factor Xa, have been developed. Specifically, agents targeting thrombin (dabigatran) and factor Xa (apixaban and rivaroxaban) have either reached late stages of clinical development (apixaban) or have received approval (dabigatran, rivaroxaban) by the US Food and Drug Administration for use in patients with nonvalvular AF. The promising results derived from large-scale clinical trials with these agents compared to warfarin expand the available therapeutic options for the prevention of stroke and systemic embolization in this rapidly increasing patient population. Here we present a general guidance pathway for the initiation and selection of oral anticoagulants in patients with AF.
Duke Scholars
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Related Subject Headings
- Stroke
- Humans
- Factor Xa Inhibitors
- Cardiovascular System & Hematology
- Atrial Fibrillation
- Antithrombins
- Anticoagulants
- 4203 Health services and systems
- 3202 Clinical sciences
- 3201 Cardiovascular medicine and haematology
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Stroke
- Humans
- Factor Xa Inhibitors
- Cardiovascular System & Hematology
- Atrial Fibrillation
- Antithrombins
- Anticoagulants
- 4203 Health services and systems
- 3202 Clinical sciences
- 3201 Cardiovascular medicine and haematology