New Oral Anticoagulant Agents for Stroke Prevention

Abstract

Stroke associated with non-valvular atrial fibrillation is one of the most important subtypes of stroke, and its importance is becoming more apparent in elderly. Until now, warfarin had been one of the only treatment options for long-term anticoagulation of patients with atrial fibrillation, venous thromboembolism, or other conditions that require chronic anticoagulation. New oral anticoagulants are being evaluated in the prevention of stroke associated with non-valvular atrial fibrillation in addition to treatment with the conventional oral anticoagulant, warfarin. Dabigatran, rivaroxaban, apixaban and edoxaban are the new anticoagulants.

Keywords

• Stroke,atrial fibrillation,new oral anticoagulant

İNMENİN ÖNLENMESİNDE YENİ ORAL ANTİKOAGÜLAN AJANLAR

Abstract

Non-valvüler atrial fibrilasyonla ilişkili inme en sık strok tipleri arasında bulunmakta ve yaşlı popülasyonda gün geçtikçe önemi artmaktadır. Günümüze kadar venöz tromboembolizm ve atrial fibrilasyon gibi kronik antikoagülan tedaviye ihtiyaç duyulan durumlar için tedavi seçeneği olarak yalnız varfarin mevcuttu. Ancak günümüzde non-valvüler atrial fibrilasyonlu hastalarda strok önleyici olarak kullanabileceğimiz yeni oral antikoagülanlar piyasaya çıkmıştır. Bunlar dabigatran, rivaroksaban, apiksaban ve edoksabandır.

Keywords

• İnme,atrial fibrilasyon,yeni oral antikoagulan

References

1. Shchendrygina AA. The use of dabigatran for prevention of ischemic stroke in patiets with atrial fibrillation: special features of treatment in different clinical situations. Kardiologiia. 2014; 54(9): 72-8.
2. Armbruster AL, Buehler KS, Min SH, Riley M, Daly MW. Evaluation of dabigatran for appropriateness of use and bleeding events in a community hospital setting. Am Health Drug Benefits. 2014; 7(7): 376-84.
3. Clinical Pharmacology [database online]. Tampa, FL: Gold Standart, Inc; 2012. http://clinicalpharmacolgy.com. Updated August 2012. Accessed July 30th, 2012.
4. Connolly SJ, Ezekowitz MD, Yusuf S, et al (RE- LY Steering Committee and Investigators).
5. Dabigatran versus warfarin in patients with atrial
6. fibrillation. N Engl J Med. 2009; 361(12): 1139-51.
7. Okata T, Toyoda K, Okamoto A, Miyata T, Nagatsuka K, Minematsu K. Anticoagulation intensity of rivaroxaban for stroke patients at a special low dosage in Japan. PLoS One. 2014; 26; 9(11): e113641.
8. da Silva RM. Novel oral anticoagulants in non- valvular atrial fibrillation. Cardiovasc Hematol Agents Med Chem. 2014; 12(1): 3-8.

9. Patel MR, Mahaffey KW, Garg j, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011; 365(10): 883-91.
10. Dzeshka MS, Lip GY. Antithrombotic and anticoagulant therapy for atrial fibrillation. Cardiol Clin. 2014; 32(4): 585-99.
11. Deedwania P, Huang GW. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation. Core Evid. 2012; 7: 49-59.
12. Grander CB, Alexander JH, Mc Murray JJ, et al (ARISTOTLE Committees and investigators). Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011; 365(11): 981-92.
13. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2013; 369: 2093-104.