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Novel anticoagulants and antiplatelet agents; a guide for the urologist
Author(s) -
Ellis Gidon,
John Camm Alan,
Datta Soumendra N.
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13131
Subject(s) - medicine , clopidogrel , intensive care medicine , warfarin , aspirin , vitamin k , anticoagulant , perioperative , clinical practice , dabigatran , rivaroxaban , population , venous thromboembolism , platelet aggregation inhibitor , surgery , thrombosis , atrial fibrillation , family medicine , environmental health
Novel oral anti‐coagulants ( NOAC s) are increasingly being used in clinical practice and are set to almost entirely replace the vitamin K antagonists, such as warfarin, in the near future. Similarly, new antiplatelet agents are now regularly used in place of older agents, such as aspirin and clopidogrel. In an ageing population, with an increasing burden of complex comorbidities, urologists will frequently encounter patients who will be using such agents. Some background knowledge, and an understanding, of these drugs and the issues that surround their usage, is essential. The present article will provide readers with an understanding of these new drugs, including their mechanisms of action, the up‐to‐date evidence justifying their recent introduction into clinical practice and the appropriate interval for stopping them before surgery. It will also consider the risks of perioperative bleeding for patients taking these drugs and the risks of venous thromboembolism in those in whom they are stopped. Strategies to manage anticoagulant‐associated bleeding are discussed.