Selection of Medications to Prevent Stroke Among Individuals With Atrial Fibrillation Update on Prevention of Stroke in Patients with AF

Opinion statement Vitamin K antagonists have been the only available orally active anticoagulants for decades. Although effective, their numerous limitations have driven the introduction of new oral anticoagulants (NOAs) that showed effectiveness at fixed doses without the need for routine coagulati...

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Published inCurrent treatment options in neurology Vol. 15; no. 5; pp. 583 - 592
Main Authors Testa, Luca, Fasano, Alfonso, De Sanctis, Valerio, Latini, Roberto Adriano, Latib, Azeem, Oreglia, Jacopo, De Marco, Federico, Agnifili, Mauro, Casavecchia, Matteo, Talarico, Giovanni Paolo, Lanotte, Stefania, Pizzocri, Samuele, Mattioli, Roberto, Mantica, Massimo, Bedogni, Francesco
Format Journal Article
LanguageEnglish
Published Boston Springer US 01.10.2013
Subjects
Cerebrovascular Disorders (Hp Adams Jr
Critical Care Medicine
Diabetes
Family Medicine
General Practice
Intensive
Internal Medicine
Medicine
Medicine & Public Health
Neurology
Ophthalmology
Section Editor
Prevention
Stroke
Hemorrhagic complications
Atrial fibrillation
Vitamin K antagonists
New oral anticoagulants
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Summary:Opinion statement Vitamin K antagonists have been the only available orally active anticoagulants for decades. Although effective, their numerous limitations have driven the introduction of new oral anticoagulants (NOAs) that showed effectiveness at fixed doses without the need for routine coagulation monitoring. However, the safety and efficacy observed in controlled clinical trials may be hard to translate in clinical practice. Clinical conditions as well as drug interactions may considerably impact on patient outcomes. Moreover, the inability to monitor the pharmacological activity of NOAs and the absence of any antidote in the setting of bleeding or emergent invasive procedures may limit their use. Vitamin K antagonists will be still used in many circumstances, including patients with an optimal control of the INR, with mechanical heart valves, and other indications for which these new agents have not been investigated. Nevertheless, these new agents will reduce the burden of anticoagulation management at the patient as well as Health Care level.
ISSN:1092-8480
1534-3138
DOI:10.1007/s11940-013-0248-3