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New Avenues for Anticoagulation in Atrial Fibrillation
Author(s) -
Mantha S,
Cabral K,
Ansell J
Publication year - 2013
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2012.197
Subject(s) - rivaroxaban , dabigatran , apixaban , warfarin , medicine , atrial fibrillation , clinical pharmacology , vitamin k , intensive care medicine , clinical trial , drug , randomized controlled trial , pharmacology
Vitamin K antagonists (VKAs) were, until recently, the only option for chronic anticoagulation in patients with atrial fibrillation. Three new oral anticoagulants have been tested for this indication in recent randomized trials: dabigatran, rivaroxaban, and apixaban. They offer the promise of consistent effect without the need for monitoring drug levels. Overall, efficacy and safety appear to be noninferior, and in some instances superior, to warfarin. However, the new drugs have their downsides, and switching from warfarin is not recommended for all patients. This review focuses on the available evidence and attempts to provide guidance to clinicians in the field. Clinical Pharmacology & Therapeutics (2013); 93 1, 68–77. doi: 10.1038/clpt.2012.197