Novel Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation: Dawn of a New Era

Publication/Presentation Date

1-1-2013

Abstract

Atrial fibrillation (AF) is an important cause of ischemic stroke and is the underlying cause of > 20% of all strokes, with increasing age being a risk factor. Until recently, warfarin was the only available oral anticoagulant used to decrease this risk in patients with AF. However, there are several disadvantages of warfarin use, such as the requirement for monitoring the international normalized ratio, its wide range of drug-food interactions, and its narrow therapeutic index. Thus, there has been a strong impetus for the development of newer oral anticoagulants with predictable pharmacokinetics that obviate the need for monitoring the international normalized ratio. The US Food and Drug Administration has approved a direct thrombin inhibitor (dabigatran) and 2 factor Xa inhibitors (rivaroxaban and apixaban) for stroke prevention in patients with nonvalvular AF. There are several other new oral anticoagulant agents on the horizon, including the factor Xa inhibitor edoxaban. This review article discusses the pharmacological properties, clinical trial data, and practical issues associated with the use of these novel oral anticoagulants.

Volume

125

Issue

1

First Page

34

Last Page

44

ISSN

1941-9260

Disciplines

Cardiology | Chemicals and Drugs | Medical Sciences | Medical Specialties | Medicine and Health Sciences

PubMedID

23391669

Department(s)

Department of Medicine, Cardiology Division

Document Type

Article

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