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Stroke anticoagulants atrial fibrillation apixaban dabigatran rivaroxaban edoxaban thromboembolism antithrombotic

Matthias Hammwöhner, Andreas Goette
Atrial Fibrillation (AF) is accompanied by an increased risk for thromboembolic events in most affected patients. Current guidelines therefore recommend antithrombotic therapy with vitamin K antagonist (VKA) or non VKA oral anticoagulant (NOAC) in the majority of AF patients. Current AF treatment guidelines recommend that only patients younger than 65 years of age with lone AF, meaning without further concomitant risk factors for thromboembolic events should not be anticoagulated. NOACs, like the direct thrombin inhibitor dabigatran and the factor X inhibitors rivaroxaban, apixaban, and edoxaban have undergone large phase III clinical trials concerning treatment efficacy and bleeding risk in comparison to the VKA warfarin...
December 2015: Journal of Cardiovascular Pharmacology
Qinmei Xiong, Gregory Y H Lip
Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, which can potentially increases the risk of stroke by five-fold, thus, resulting in high public healthcare burden. Stroke prevention is vital in the management of AF patients. Vitamin K antagonists (VKA, eg, warfarin) have been the mainstay treatment to prevent ischemic stroke and systemic thromboembolism in AF patients for several decades. Despite the efficacy of warfarin, its limitations have recently driven the advent of some new antithrombotic agents, the non-VKA oral anticoagulant (NOACs, including dabigatran, rivaroxaban, apixaban, and edoxaban)...
February 2015: Current Treatment Options in Neurology
Georg Noll, Sarah Noll, David Hürlimann
Atrial fibrillation (AF), the most frequent sustained arrhythmia, is associated with an increased risk of thromboembolic events. The risk of stroke depends on risk factors such as age, hypertension, heart failure, and vascular disease. Thus, antithrombotic therapy is a cornerstone in the management of AF. Warfarin is successfully used to reduce thromboembolic events. More recently, direct thrombin (dabigatran) and factor Xa (apixaban, edoxaban, rivaroxaban) inhibitors have been compared to warfarin in large randomized trials...
April 2014: Seminars in Hematology
Andrew Krasner, Jonathan L Halperin
Patients with atrial fibrillation who have risk factors for thromboembolism benefit from chronic oral anticoagulation therapy, and antiplatelet therapy alone is of relatively little benefit for prevention of ischemic stroke and systemic embolism. Patients undergoing percutaneous coronary intervention with drug-eluting stents require dual antiplatelet therapy with aspirin and a thienopyridine for 3 to 12 months or more prevention of stent thrombosis and recurrent ischemic events. When patients with atrial fibrillation undergo percutaneous coronary intervention, the need to combine dual antiplatelet therapy and warfarin raises the risk of major bleeding complications considerably...
July 2013: Current Cardiology Reports
Fabrizio Ricci, Giulia Renda, Raffaele De Caterina
Prevention of atrial fibrillation (AF)-related stroke and thromboembolism is an important part of AF management. However, stroke risk varies considerably with associated morbidities and risk factors. Several stroke risk stratification schemes have been developed, and categorize patients' stroke risk into categories based on the presence and combination of risk factors. Based on the perceived level of risk, current guidelines recommend that patients with AF receive some form of antithrombotic therapy. Despite guideline recommendations, however, many patients with AF do not receive adequate thromboprophylaxis...
January 2013: Giornale Italiano di Cardiologia
R Lakshmi Narasimhan Ranganathan, P Venkatesh
Atrial fibrillation is a common arrhythmia that increases the risk of stroke by 4.5 times. Anticoagulant/antithrombotic therapy in atrial fibrillation has been inconsistent and inappropriate. Warfarin enjoyed the monopoly of being the primary medication used to reduce the risk of thromboembolic events. Warfarin has many limitations in its use as an ideal anticoagulant. To overcome this difficulty, now there are two main alternative groups to warfarin namely, direct thrombin inhibitors (ximelagatran and dabigatran) and factor Xa inhibitors (apixaban, rivaroxaban, edoxaban, etc...
October 2013: Journal of Neural Transmission
Maria M Niespialowska-Steuden, Vias Markides, Diana A Gorog
Atrial fibrillation (AF) is the most common cardiac arrhythmia. It is estimated that 1 in 4 individuals aged 40 years or above will develop at least 1 episode of AF during their lifetime. Stroke is a leading cause of serious, long-term disability and death, and a major socioeconomic burden in developed countries. The major risk factor for thromboembolic stroke is AF. Oral antithrombotic treatment for AF patients has been limited to vitamin K antagonists for more than 60 years. Treatment with warfarin can reduce, but fails to abolish thromboembolic stroke associated with AF...
June 2012: Pharmacology & Therapeutics
Stylianos Tzeis, George Andrikopoulos
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an increased risk of thromboembolic complications and stroke. Therefore, the implementation of thromboembolic preventive treatment is the cornerstone of quality management in AF patients. During the last 60 years, vitamin K antagonists remain at the forefront of antithrombotic management of AF patients. Randomized trials have demonstrated their superiority over aspirin as well as over the combination of aspirin and clopidogrel with similar safety profile...
April 2012: Angiology
Prakash C Deedwania, Grace W Huang
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is an independent risk factor of potentially catastrophic cardioembolic strokes. AF patients are categorized into high-, intermediate-, and low-risk for thromboembolic complications using the CHADS(2) or CHA(2)DS(2)-VASc scoring system. Oral anticoagulation using warfarin has been the standard therapy for stroke prevention in intermediate- to high-risk AF patients. However, warfarin use has been limited by several factors such as narrow therapeutic windows, drug-drug and drug-food interactions, and hemorrhagic complications...
August 1, 2011: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
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