Novel Oral Anticoagulation in Management of Venous Thromboembolism, Atrial Fibrillation, and Acute Coronary Syndrome

• Published in: Clinical and applied thrombosis/hemostasis Vol. 18; no. 5; pp. 476 - 486
• Main Authors: Khemasuwan, Danai, Suramaethakul, Nuttanun
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2012; SAGE PUBLICATIONS, INC
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - drug therapy; Acute coronary syndromes; Administration, Oral; Anticoagulants; Antithrombins - therapeutic use; Atrial Fibrillation - blood; Atrial Fibrillation - drug therapy; Benzimidazoles - therapeutic use; beta-Alanine - analogs & derivatives; beta-Alanine - therapeutic use; Dabigatran; Factor Xa - metabolism; Factor Xa Inhibitors; Health risk assessment; Humans; Morpholines - therapeutic use; Pulmonary embolisms; Pyrazoles - therapeutic use; Pyridones - therapeutic use; Rivaroxaban; Thiophenes - therapeutic use; Thromboembolism; Venous Thromboembolism - blood; Venous Thromboembolism - drug therapy; Vitamin K - antagonists & inhibitors; Vitamin K - blood; Warfarin - therapeutic use; anticoagulants; thrombosis prophylaxis; deep venous thrombosis; pulmonary embolism; venous thromboembolism
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029612438957

Venous thromboembolism (VTE) is a major public health concern since the incidence of VTE rises substantially with age. Furthermore, the diagnosis can be elusive since patients can present differently, causing delay in diagnosis and initiation of treatment and resulting in major morbidity and mortality. In addition to accuracy and precision in diagnosis, antithrombotic therapies are the cornerstones of VTE management. In traditional paradigm, vitamin K antagonists (warfarin), indirect factor Xa inhibitors, and heparin are the foundation in management of VTE. Warfarin has been the only available oral anticoagulant therapy for several decades. Although warfarin is effective in both treatment and prophylaxis against VTE, there are several limitations. Therefore, the novel anticoagulation therapies, including rivaroxaban, apixaban, and dabigatran etexilate, have apparent advantages over warfarin in terms of clinical efficacy and adverse effects. The objective of this review is to describe the background and clinical implications of these novel anticoagulants.