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New oral anticoagulants: a practical guide for physicians
Rocio Hinojar1, Jose Julio Jiménez-Natcher2, Covadonga Fernández-Golfín2
1Cardiovascular Department, University Hospital Ramón y Cajal, Carretera de Colmenar Km 9.100, Madrid 28034, Spain rociohinojar@gmail.com.
European Heart Journal. Cardiovascular Pharmacotherapy
|August 18, 2016
Summary
New oral anticoagulants (NOACs) offer a stroke prevention alternative to vitamin K antagonists (VKAs) for non-valvular atrial fibrillation (AF) patients. This review provides clinical algorithms for safe and effective NOAC use, addressing barriers to their expansion.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Non-valvular atrial fibrillation (AF) poses a significant stroke risk.
- Vitamin K antagonists (VKAs) are traditional anticoagulants but require frequent monitoring.
- Newer oral anticoagulants (NOACs) present an alternative with distinct advantages and challenges.
Purpose of the Study:
- To review current New oral anticoagulants (NOACs) available for stroke prevention in non-valvular atrial fibrillation (AF).
- To provide practical algorithms for the clinical application of NOACs.
- To discuss factors influencing the adoption and use of NOACs.
Main Methods:
- Literature review of current NOACs and their properties.
- Development of clinical algorithms for NOAC implementation.
- Discussion of clinical experience and barriers to NOAC use.
Main Results:
- NOACs offer stroke prevention in AF without routine INR monitoring.
- Pharmacological properties of NOACs are generally favorable.
- Barriers to NOAC expansion include lack of antidote, cost, and concerns in renal impairment.
Conclusions:
- NOACs are a viable alternative to VKAs for stroke prevention in AF.
- Clinical experience and practical guidance are crucial for safe and effective NOAC utilization.
- Addressing barriers is key to increasing NOAC adoption in clinical practice.
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