TY - JOUR
T1 - Current trends in the use of anticoagulant pharmacotherapy in the United Kingdom are changes on the horizon?
AU - Kotalczyk, Agnieszka
AU - Gue, Ying X
AU - Potpara, Tatjana S
AU - Lip, Gregory Y H
PY - 2021
Y1 - 2021
N2 - INTRODUCTION: Effective stroke prevention with oral anticoagulation (OAC) reduces the risk of stroke and death among patients with atrial fibrillation (AF). For most patients with AF, treatment options include vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOACs). NOACs have been introduced as an alternative to VKAs, and their use has been steadily increasing in the United Kingdom and Europe over a decade. In randomized clinical trials, NOACs had a favorable risk-benefit profile as compared to warfarin. However, there is a concern about their long-term safety in clinical practice, especially in high-risk patients. There have been a number of registries and surveys based on the real-world patients with AF which has been conducted and published, providing data on contemporary AF management.AREAS COVERED: In this narrative review, the authors discuss current trends in the use of OAC in the United Kingdom and Europe, considering the potential directions for future anticoagulant therapy in patients with AF.EXPERT OPINION: The increasing prevalence of AF and AF-related comorbidities proves the need for comprehensive prevention and management strategies. The challenge is the optimization of therapy for each patient. However, there are still gaps in optimal stroke prevention, and the mortality rates remain high in patients with AF.
AB - INTRODUCTION: Effective stroke prevention with oral anticoagulation (OAC) reduces the risk of stroke and death among patients with atrial fibrillation (AF). For most patients with AF, treatment options include vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOACs). NOACs have been introduced as an alternative to VKAs, and their use has been steadily increasing in the United Kingdom and Europe over a decade. In randomized clinical trials, NOACs had a favorable risk-benefit profile as compared to warfarin. However, there is a concern about their long-term safety in clinical practice, especially in high-risk patients. There have been a number of registries and surveys based on the real-world patients with AF which has been conducted and published, providing data on contemporary AF management.AREAS COVERED: In this narrative review, the authors discuss current trends in the use of OAC in the United Kingdom and Europe, considering the potential directions for future anticoagulant therapy in patients with AF.EXPERT OPINION: The increasing prevalence of AF and AF-related comorbidities proves the need for comprehensive prevention and management strategies. The challenge is the optimization of therapy for each patient. However, there are still gaps in optimal stroke prevention, and the mortality rates remain high in patients with AF.
KW - Atrial fibrillation
KW - bleeding
KW - non-vitamin K antagonists
KW - oral anticoagulation
KW - stroke prevention
KW - vitamin K antagonists
UR - http://www.scopus.com/inward/record.url?scp=85100172774&partnerID=8YFLogxK
U2 - 10.1080/14656566.2021.1879050
DO - 10.1080/14656566.2021.1879050
M3 - Review article
C2 - 33491506
SN - 1465-6566
VL - 22
SP - 1061
EP - 1070
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
IS - 8
ER -