Roles of New Oral Anticoagulants in Stroke Patients with Nonvalvular Atrial Fibrillation
Keywords:
Anticoagulants, atrial fibrillation, embolism, NOACs, strokeAbstract
The important objectives in treating patients with nonvalvular atrial fibrillation (NVAF) are prevention from embolic events, as well as minimization of bleeding complications. Vitamin K anticoagulants (VKA) are widely used to prevent stroke and systemic embolism among these patients. However, individualized treatment based on benefits, risks, adverse effects, and other special consideration are needed. Landmark studies comparing efficacy and safety of new oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, edoxaban, and warfarin were referred for international recommendations. This article summarizes clinical trials and guidelines for NOACs use in stroke prevention.
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development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004 Aug 31;110(9):1042-6.
Reiffel JA. Atrial fibrillation and stroke: epidemiology. Am J Med. 2014 Apr;127(4):e15-6.
Fang MC, Go AS, Chang Y, Borowsky LH, Pomernacki NK, Udaltsova N, Singer DE. Long-term survival after ischemic stroke in patients with atrial fibrillation. Neurology. 2014 Mar 25;82(12):1033-7.
Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the
Swedish Atrial Fibrillation cohort study. Eur Heart J. 2012 Jun;33(12):1500-10.
Lip GY. Implications of the CHA(2)DS(2)-VASc and HAS-BLED Scores for thromboprophylaxis in atrial fibrillation. Am J Med. 2011 Feb;124(2):111-4.
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J,
Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients
with atrial fibrillation. N Engl J Med. 2009 Sep 17;361(12):1139-51.
Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Piccini JP, Becker RC, Nessel CC, Paolini JF, Berkowitz SD, Fox KA, Califf RM; ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011 Sep 8;365(10):883-91.
Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS,
Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J, Wallentin L; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011 Sep 15;365(11):981-92.
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, Waldo AL, Ezekowitz MD, Weitz JI, Špinar J, Ruzyllo W, Ruda M, Koretsune
Y, Betcher J, Shi M, Grip LT, Patel SP, Patel I, Hanyok JJ, Mercuri M, Antman EM; ENGAGE AFTIMI 48 Investigators. Edoxaban versus warfarin in
patients with atrial fibrillation. N Engl J Med. 2013 Nov 28;369(22):2093-104.
Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman
EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised
trials. Lancet. 2014 Mar 15;383(9921):955-62.
Heidbuchel H1, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P; European Heart Rhythm Association. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013 May;15(5):625-51.
Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, Chaturvedi S, Creager MA, Eckel RH, Elkind MS, Fornage M, Goldstein LB, Greenberg
SM, Horvath SE, Iadecola C, Jauch EC, Moore WS, Wilson JA; American Heart Association Stroke Council; Council on Cardiovascular and Stroke
Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary
prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014
Dec;45(12):3754-832.
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, Fang MC, Fisher M, Furie KL, Heck DV, Johnston SC, Kasner SE, Kittner
SJ, Mitchell PH, Rich MW, Richardson D, Schwamm LH, Wilson JA; American Heart Association Stroke Council, Council on Cardiovascular and Stroke
Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke
and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Jul;45(7):2160-236.
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2019-02-14
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สุวัชรังกูร ส. Roles of New Oral Anticoagulants in Stroke Patients with Nonvalvular Atrial Fibrillation. J Thai Stroke Soc [Internet]. 2019 Feb. 14 [cited 2024 Jul. 27];15(2):105-12. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172127
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
