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Hamostaseologie 2021; 41(01): 035-041
DOI: 10.1055/a-1329-2430
Review Article

Direct Oral Anticoagulants in Atrial Fibrillation: Practical Considerations and Remaining Issues

Jan Beyer-Westendorf
1   Thrombosis Research Unit, Department of Medicine I, Division Hematology, University Hospital “Carl Gustav Carus” Dresden, Dresden, Germany
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Abstract

Preventing thromboembolic events, while minimizing bleeding risks, remains challenging when managing patients with atrial fibrillation. Despite large and successful trial programs, several clinical concerns remain which commonly relate to fears of over- or underexposure to drugs and unfavorable outcomes. After a short summary of the main phase III trial findings, this short review discusses the evidence and clinical relevance of common clinical concerns (correct direct oral anticoagulant [DOAC] dosing; DOAC in moderate-to-severe renal impairment; and the relevance of fasting, nasogastric tube feeding, or high body mass index) on DOAC plasma levels. Finally, the need for specific DOAC antidotes will be addressed.

Keywords

direct oral anticoagulants - atrial fibrillation - stroke


Publication History

Received: 16 October 2020

Accepted: 03 December 2020

Article published online:
15 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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