Abstract
Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing IS/SE with a lower rate of major bleeding. Various analyses from the large Phase III randomised trials demonstrated different efficacy and safety of NOACs in specific subgroups of patients. The randomised trials are supplemented by effectiveness and safety data from real world observational cohorts following the availability of these drugs for use in everyday clinical practice. Given the clinical heterogeneity of AF patients, the available data from trials and real-world studies allow us to fit the right NOAC to the particular patient's characteristics, with the aim of optimising outcomes for individual patient. This review article aims to provide a summary of the evidence on the performance of NOACs in AF patients with specific clinical characteristics. Evidence-based suggestions are presented to provide a simple and viable strategy for clinicians for the choice of a particular NOAC.
Original language | English |
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Journal | Annals of Medicine |
Volume | 50 |
Issue number | 4 |
Pages (from-to) | 288-302 |
Number of pages | 15 |
ISSN | 0785-3890 |
DOIs | |
Publication status | Published - 2018 |
Bibliographical note
Corrigendum in: Annals of Medicine, 2018; vol. 50(4):361.https://doi.org/10.1080/07853890.2018.1468134
Keywords
- Atrial fibrillation
- clinical situations
- new oral anticoagulant
- non-vitamin K oral anticoagulants
- stroke prevention