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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

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Direct acting oral anticoagulant: Bench to bedside

D S Chadha1, P Bharadwaj2

  • 1Senior Advisor (Medicine & Cardiology), Command Hospital (Air Force), Bangalore, India.

Medical Journal, Armed Forces India
|August 10, 2017
PubMed

Insights

Newer direct-acting oral anticoagulants offer improved safety and efficacy over Vitamin K antagonists for preventing stroke and venous thromboembolism. While they have limitations, antidotes enhance their safety profile.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Hematology

Background:

  • Vitamin K antagonists (VKAs) are effective oral anticoagulants but require constant monitoring due to narrow therapeutic windows and interactions.
  • Genetic variability and drug/food interactions lead to unpredictable anticoagulant effects with VKAs.

Purpose of the Study:

  • To review direct-acting oral anticoagulants (DOACs) for stroke prevention in nonvalvular atrial fibrillation and venous thromboembolism treatment/prevention.
  • To compare the clinical uses and limitations of DOACs versus VKAs.

Main Methods:

  • Review of current literature on DOACs, including direct thrombin inhibitors and factor Xa inhibitors.
  • Analysis of safety and efficacy profiles, clinical applications, and limitations of DOACs.

Main Results:

  • DOACs (dabigatran, rivaroxaban, apixaban, edoxaban) demonstrate better safety and efficacy than VKAs.
  • DOACs have limitations including gastrointestinal bleeding risk (except apixaban) and thrombotic risk upon cessation, but antidotes improve safety.

Conclusions:

  • DOACs represent a significant advancement in oral anticoagulation therapy.
  • Understanding the clinical uses and limitations of DOACs is crucial for optimizing patient care.
Keywords:
Atrial fibrillationFactor Xa inhibitorsOral anticoagulantsThrombin inhibitors

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