New frontiers in anticoagulation: non vitamin-K oral anticoagulants in stroke prevention.

Abstract:

INTRODUCTION:Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists. New evidences have suggested their use in treatment of elderly people, in patients with renal insufficiency or with antiphospholipid antibody syndrome. In addition, the use of antidotes, which rapidly reverse the anticoagulant effect of the NOACs, could be useful in bleeding, during emergency procedures, or in case of overdose.

journal_name

Expert Rev Neurother

authors

Arnao V,Riolo M,Tuttolomondo A,Pinto A,Fierro B,Aridon P

doi

10.1080/14737175.2017.1268053

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

539-552

issue

6

eissn

1473-7175

issn

1744-8360

journal_volume

17

pub_type

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