The new direct oral anticoagulants in special indications: rationale and preliminary data in cancer, mechanical heart valves, anti-phospholipid syndrome, and heparin-induced thrombocytopenia and beyond.

Abstract:

:The present review will briefly summarize the interplay between coagulation and inflammation, highlighting possible effects of direct inhibition of factor Xa and thrombin beyond anticoagulation. Additionally, the rationale for the use of the new direct oral anticoagulants (DOACs) for indications such as cancer-associated venous thromboembolism (CAT), mechanical heart valves, thrombotic anti-phospholipid syndrome (APS), and heparin-induced thrombocytopenia (HIT) will be explored. Published data on patients with cancer or mechanical heart valves treated with DOAC will be discussed, as well as planned studies in APS and HIT. Although at the present time published evidence is insufficient for recommending DOAC in the above-mentioned indications, there are good arguments in favor of clinical trials investigating their efficacy in these contexts. Direct inhibition of factor Xa or thrombin may reveal interesting effects beyond anticoagulation as well.

journal_name

Semin Hematol

journal_title

Seminars in hematology

authors

Alberio L

doi

10.1053/j.seminhematol.2014.03.002

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

152-6

issue

2

eissn

0037-1963

issn

1532-8686

pii

S0037-1963(14)00011-0

journal_volume

51

pub_type

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