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Semin Thromb Hemost 2015; 41(02): 146-153
DOI: 10.1055/s-0035-1544156
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparative Efficacy and Safety of the Non–Vitamin K Antagonist Oral Anticoagulants for Patients with Nonvalvular Atrial Fibrillation

Keitaro Senoo
1   Centre for Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, United Kingdom
,
Gregory Y. H. Lip
1   Centre for Cardiovascular Sciences, City Hospital, University of Birmingham, Birmingham, United Kingdom
2   Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
› Author Affiliations
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Publication History

Publication Date:
15 February 2015 (online)

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Abstract

The non–vitamin K antagonist oral anticoagulants (NOACs), such as the thrombin inhibitor (dabigatran) and the direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), have been shown to be at least as efficacious and safe as conventional oral anticoagulants, such as the vitamin K antagonists (VKAs) (e.g., warfarin), for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). Each NOAC has various advantages and specific features, and therefore decisions regarding appropriate stroke prevention require individual assessment of stroke and bleeding risk on anticoagulation with VKA therapy and NOACs when starting on any of these drugs. This review briefly describes the results of the four NOACs clinical randomized trials and discusses how they might impact clinical practice and choice of anticoagulants in atrial fibrillation patients. Moreover, this review discusses the differences of the proposed management of antithrombotic therapy in several international guidelines and pragmatic issues of NOACs for stroke prophylaxis.

Keywords

non-VKA oral anticoagulants - vitamin K antagonist - atrial fibrillation - stroke prevention - clinical trial
 

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