Timeless therapeutics: cardiac indications for vitamin K antagonists in clinical practice

Area of Science:

• Cardiology
• Pharmacology

Background:

• Anticoagulation is vital for cardiovascular disease management.
• Direct oral anticoagulants (DOACs) are effective for stroke prevention in atrial fibrillation (AF) and venous thromboembolism.
• However, Vitamin K antagonists (VKAs) are preferred or offer uncertain DOAC benefits in specific patient groups.

Purpose of the Study:

• To review cardiac indications and patient characteristics where VKAs are necessary.
• To discuss the management principles of VKA therapy.

Main Methods:

• Literature review of randomized controlled trials and clinical guidelines.
• Analysis of specific patient populations and cardiac conditions.

Main Results:

• VKAs are indicated for mechanical heart valves, AF with moderate-to-severe mitral stenosis, left ventricular/atrial thrombus, and frail elderly patients.
• DOAC benefits are uncertain in these specific scenarios.

Conclusions:

• VKAs will remain essential in cardiovascular disease management.
• Understanding VKA indications and management is critical for patient care.