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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Non-Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation

Anna Plitt1, Christian T Ruff2, Robert P Giugliano2

  • 1Department of Internal Medicine, Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029-6574, USA.

Hematology/Oncology Clinics of North America
|September 18, 2016
PubMed

Insights

Non-VKA oral anticoagulants (NOACs) offer an alternative to warfarin for atrial fibrillation (AF) patients. This review covers NOAC properties, trials, special populations, and bleeding management strategies.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Vitamin K antagonists (VKAs) have been the long-standing standard for atrial fibrillation (AF) treatment.
  • Limitations of VKAs necessitate alternative therapies for thromboembolism prevention.

Purpose of the Study:

  • To provide an overview of atrial fibrillation (AF).
  • To summarize the properties of non-VKA oral anticoagulants (NOACs).
  • To review landmark clinical trials and expert recommendations on NOACs.

Main Methods:

  • Literature review of landmark trials and expert opinions.
  • Synthesis of data on NOAC properties and clinical applications.
  • Analysis of NOAC use in special populations and clinical scenarios.

Main Results:

  • Four NOACs are approved for preventing thromboembolism in nonvalvular AF.
  • NOACs present distinct properties and efficacy profiles compared to VKAs.
  • Data on NOACs in special populations and clinical scenarios are presented.

Conclusions:

  • NOACs represent a significant advancement in anticoagulation for AF.
  • Expert recommendations address bleeding management and reversal strategies for NOACs.
  • Further research and clinical experience will refine NOAC utilization in diverse patient groups.

Keywords:
ApixabanAtrial fibrillationDabigatranEdoxabanNOACRivaroxaban

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