The periprocedural management of novel oral anticoagulants in patients with nonvalvular atrial fibrillation: Rationale and a summary of the available evidence from phase 3 clinical trials

• Published in: The American heart journal Vol. 169; no. 3; pp. 315 - 322
• Main Authors: Krishnamoorthy, Arun, MD, Sherwood, Matthew W., MD, MHS, Lopes, Renato D., MD, MHS, PhD, Becker, Richard C., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2015; Elsevier Limited
• Subjects: Administration, Oral; Anticoagulants; Anticoagulants - administration & dosage; Anticoagulants - therapeutic use; Antithrombins - administration & dosage; Antithrombins - therapeutic use; Atrial Fibrillation - drug therapy; Benzimidazoles - therapeutic use; beta-Alanine - analogs & derivatives; beta-Alanine - therapeutic use; Bioavailability; Biopsy; Bone surgery; Cardiac arrhythmia; Cardiovascular; Clinical medicine; Clinical trials; Clinical Trials, Phase III as Topic; Dabigatran; Drug dosages; Drug therapy; Embolisms; Endoscopy; Factor Xa Inhibitors - therapeutic use; Humans; Laboratories; Morpholines - therapeutic use; Older people; Orthopedics; Patients; Plasma; Rivaroxaban; Stroke; Thiophenes - therapeutic use; Thoracic surgery; Treatment Outcome
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2014.12.008

The novel oral anticoagulants (NOACs) have rapidly emerged as an alternative therapy to warfarin. Several recent phase 3 randomized control trials have demonstrated the efficacy and safety of the NOACs in the treatment for patients with nonvalvular atrial fibrillation. As the NOACs are incorporated in clinical practice, questions have begun to arise concerning their optimal use in commonly encountered situations. In this review, we provide a summary of the available evidence from the phase 3 randomized control trials specifically with regard to 1 such scenario, the periprocedural management of NOACs, with a goal of providing guidance for practicing clinicians.