Related Experiment Video

Updated: May 8, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

New oral anticoagulants in atrial fibrillation

Alexander G G Turpie1

  • 1Department of Medicine, HHS-General Hospital, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2. turpiea@mcmaster.ca

European Heart Journal
|December 22, 2007
PubMed

Insights

Novel anticoagulants targeting Factor Xa and thrombin offer new options for stroke prevention in atrial fibrillation (AF) patients, potentially overcoming limitations of current therapies like warfarin.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hematology

Background:

  • Atrial fibrillation (AF) significantly increases stroke risk.
  • Current antithrombotic therapies include aspirin and vitamin K antagonists (VKAs), which have limitations like unpredictable effects and need for monitoring.
  • VKAs require regular coagulation monitoring and dose adjustments.

Purpose of the Study:

  • To review the development of novel oral anticoagulants for stroke prevention in AF patients.
  • To highlight emerging therapies targeting the coagulation pathway, specifically Factor Xa and Factor IIa inhibitors.
  • To discuss the potential of these new agents to overcome VKA limitations.

Main Methods:

  • Review of clinical development pathways for anticoagulants.
  • Identification of novel anticoagulants targeting Factor Xa and Factor IIa.
  • Summary of ongoing and planned studies for stroke prevention in AF.

Main Results:

  • Several oral direct Factor Xa inhibitors (e.g., rivaroxaban, apixaban) are in clinical development.
  • Dabigatran is the only oral direct thrombin inhibitor in late-stage development.
  • These novel agents are expected to offer improved therapeutic options.

Conclusions:

  • Novel anticoagulants targeting Factor Xa and thrombin are poised to become the next generation of therapies for stroke prevention in AF.
  • These agents aim to provide more predictable pharmacological effects compared to VKAs.
  • Further studies are ongoing to evaluate their efficacy and safety in AF patients.

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology10:46

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

Published on: May 26, 2015

Related Concept Videos

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...