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Updated: May 5, 2026
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
[Evidence of novel oral anticoagulants (NOAC)]
1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
Abstract:
Novel oral anticoagulants (NOAC) such as the direct thrombin inhibitor, dabigatran, and oral factor Xa inhibitors, rivaroxaban and apixaban, have recently approved for prevention of stroke in nonvalvular atrial fibrillation (NVAF). Phase III trials have compared each of these agents to warfarin. Dabigatran was more efficacious than warfarin in reducing the risk of stroke when given at a dose of 150 mg BID to patients with NVAF. Rivaroxaban 20 mg QD was superior to warfarin in on-treatment analysis. Apixaban 5 mg BID was also found to be superior to warfarin in reducing stroke in NVAF patients. Of note, the rate of hemorrhagic stroke was much smaller in the patients treated with NOAC than those with warfarin. NOAC offer a good therapeutic option for prevention of stroke in NVAF patients.
Insights
Novel oral anticoagulants (NOAC) are effective alternatives to warfarin for preventing stroke in nonvalvular atrial fibrillation (NVAF). These new drugs demonstrated superior efficacy and a lower risk of bleeding in clinical trials.
Area of Science:
- Cardiology
- Pharmacology
- Neurology
Background:
- Nonvalvular atrial fibrillation (NVAF) increases stroke risk.
- Warfarin has been the standard anticoagulant but has limitations.
- Novel oral anticoagulants (NOAC) offer new therapeutic options.
Purpose of the Study:
- To compare the efficacy and safety of NOAC versus warfarin for stroke prevention in NVAF.
- To evaluate direct thrombin inhibitors and factor Xa inhibitors.
Main Methods:
- Systematic review of Phase III clinical trials.
- Comparison of dabigatran, rivaroxaban, and apixaban against warfarin.
- Analysis of stroke risk and hemorrhagic events.
Main Results:
- Dabigatran 150 mg BID showed greater efficacy than warfarin.
- Rivaroxaban 20 mg QD was superior to warfarin in on-treatment analysis.
- Apixaban 5 mg BID was also superior to warfarin in reducing stroke.
- NOAC significantly reduced the rate of hemorrhagic stroke compared to warfarin.
Conclusions:
- NOAC represent a valuable therapeutic option for stroke prevention in NVAF patients.
- NOAC offer improved efficacy and safety profiles over warfarin.
- These findings support the use of NOAC in routine clinical practice for NVAF.
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