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

Published on: February 26, 2013

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Current and emerging pharmacotherapy for ischemic stroke prevention in patients with atrial fibrillation

Orsolya Székely1, Kazuo Miyazawa1, Gregory Yoke Hong Lip1,2,3

  • 1a Institute of Cardiovascular Sciences , University of Birmingham , Birmingham , UK.

Expert Opinion on Pharmacotherapy
|October 26, 2018
PubMed

Insights

Atrial fibrillation (AF) stroke prevention relies on anticoagulation. While novel oral anticoagulants (NOACs) offer advantages over vitamin K antagonists (VKAs), limitations necessitate developing new anticoagulant strategies.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hematology

Background:

  • Atrial fibrillation (AF) increases stroke risk via thromboembolism.
  • Anticoagulation is crucial for preventing thromboembolic events in AF patients.
  • Traditional anticoagulants include heparin, fondaparinux, and vitamin K antagonists (VKAs).

Purpose of the Study:

  • To review current and emerging pharmacotherapies for ischemic stroke prevention in AF.
  • To examine novel targets within the coagulation cascade for anticoagulant drug development.
  • To assess investigational anticoagulant drugs in preclinical and clinical studies.

Main Methods:

  • Literature review of current and emerging anticoagulant therapies.
  • Analysis of data on novel therapeutic targets in the coagulation cascade.
  • Evaluation of preclinical and clinical studies on investigational anticoagulant drugs.

Main Results:

  • Non-vitamin K antagonist oral anticoagulants (NOACs) represent a significant advancement over VKAs.
  • NOACs offer improved efficacy, safety, and convenience compared to VKAs.
  • Limitations of NOACs include use in severe renal impairment, mechanical heart valves, high bleeding risks, and lack of standard monitoring/reversal agents.

Conclusions:

  • Despite NOAC advancements, limitations persist, driving research into new anticoagulant strategies.
  • Development of novel anticoagulants targeting the hemostatic pathway is ongoing.
  • Future research aims to overcome current limitations and improve stroke prevention in AF.

Keywords:
Atrial fibrillationanticoagulationcardiovascular diseasecoagulation cascadeischemic strokepharmacotherapystroke prevention

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