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Considerations for use of direct oral anticoagulants in arterial disease

Deborah M Siegal1,2, Sonia S Anand3,4,5

  • 1Department of Medicine University of Ottawa Ottawa ON Canada.

Research and Practice in Thrombosis and Haemostasis
|June 7, 2021
PubMed

Insights

Direct oral anticoagulants (DOACs) show promise in managing cardiovascular diseases like stroke and peripheral arterial disease. This review examines DOACs alongside antiplatelet therapies for better patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Cardiovascular diseases caused 18 million deaths in 2017.
  • Despite advances, patients face significant risks of recurrent cardiovascular events.
  • Effective anticoagulation strategies are crucial for managing these conditions.

Purpose of the Study:

  • To review randomized clinical trials on direct oral anticoagulants (DOACs).
  • To evaluate DOACs in acute coronary syndromes, ischemic stroke, and peripheral arterial disease.
  • To present considerations for combined DOAC and antiplatelet therapy.

Main Methods:

  • Narrative review of randomized clinical trials.
  • Focus on studies evaluating DOACs for specific cardiovascular conditions.
  • Analysis of treatment strategies including single/dual antiplatelet therapy and low-dose DOACs.

Main Results:

  • DOACs are evaluated for acute coronary syndromes, noncardioembolic ischemic stroke, embolic stroke of undetermined source, and peripheral arterial disease.
  • The review discusses the use of single antiplatelet therapy, dual antiplatelet therapy, or low-dose DOACs with antiplatelet therapy.
  • Considerations for optimizing treatment regimens are presented.

Conclusions:

  • DOACs represent an important therapeutic option in managing various cardiovascular conditions.
  • Combining DOACs with antiplatelet therapy requires careful consideration of risks and benefits.
  • Further research may refine optimal anticoagulation strategies for these patient populations.

Keywords:
acute coronary syndromeanticoagulantsbrain ischemiadirect oral anticoagulantsperipheral arterial diseaseplatelet aggregation inhibitorsstroke

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