Novel Pharmacotherapies for the Prevention of Stroke or Systemic Embolism in Adults with Non-valvular Atrial Fibrillation - Part 2

10.5083/ejcm.20424884.116 , Cite or Link Using DOI
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Christos Dresios MD, Gregory Y H Lip MD

Over the last decade, a paradigm shift is apparent in the field of stroke prevention in atrial fibrillation (AF). For more than 6 decades, warfarin has represented the mainstay of anticoagulation therapy when used in AF patients. However, warfarin has important disadvantages, which limit its use in clinical practice. The recent emergence of novel oral anticoagulant drugs (NOACs) that overcome many of limitations of warfarin has allowed the provision of effective stroke prevention for many more patients with AF, as these drugs have a favorable efficacy–safety profile but also certain pharmacokinetic and pharmacodynamic properties that render periodic anticoagulant monitoring and dose adjustments unnecessary.

The NOACs fall into 2 broad categories, the oral direct thrombin inhibitors (dabigatran) and the oral factor Xa inhibitors (rivaroxaban, apixaban).The scope of this manuscript is to review currently available data regarding NOACs and to address practical issues relating to the safe and effective use of NOACs in clinical practice.