Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

Stephan H. Schirmer; Magnus Baumhaekel; Hans-Ruprecht Neuberger; Stefan H. Hohnloser; Isabelle C. van Gelder; Gregory Y. H. Lip; Michael Boehm

doi:10.1016/j.jacc.2010.09.017

Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

Stephan H. Schirmer^*, Magnus Baumhaekel, Hans-Ruprecht Neuberger, Stefan H. Hohnloser, Isabelle C. van Gelder, Gregory Y. H. Lip, Michael Boehm

^*Corresponding author for this work

Cardiovascular Centre (CVC)

Research output: Contribution to journal › Review article › peer-review

74 Citations (Scopus)

Abstract

Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need of regular monitoring of its anticoagulatory effect impair effectiveness and safety of VKA, causing a need for alternative anticoagulant drugs. Recently developed anticoagulants include direct thrombin antagonists such as dabigatran or factor Xa inhibitors such as rivaroxaban, apixaban, betrixaban, and edoxaban. Currently, data from a phase III clinical trial are available for dabigatran only, which show the direct thrombin antagonist to be at least noninferior in efficacy to VKA for the prevention of stroke and systemic embolism in patients with AF. This review focuses on current advances in the development of directly acting oral anticoagulant drugs and their potential to replace the VKA class of drugs in patients with AF. (J Am Coll Cardiol 2010;56:2067-76) (C) 2010 by the American College of Cardiology Foundation

Original language	English
Pages (from-to)	2067-2076
Number of pages	10
Journal	Journal of the American College of Cardiology
Volume	56
Issue number	25
DOIs	https://doi.org/10.1016/j.jacc.2010.09.017
Publication status	Published - 14-Dec-2010

Keywords

anticoagulants
atrial fibrillation
thrombin inhibitor
DIRECT THROMBIN INHIBITOR
FACTOR-XA INHIBITOR
RANDOMIZED CONTROLLED-TRIAL
PROTEASE-ACTIVATED RECEPTOR-1
TOTAL KNEE REPLACEMENT
NORMALIZED RATIO CONTROL
VENOUS THROMBOEMBOLISM
DABIGATRAN ETEXILATE
DOUBLE-BLIND
ORAL ANTICOAGULATION

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@article{d58e7d4541e84691ad33425483c356fc,

title = "Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments",

abstract = "Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need of regular monitoring of its anticoagulatory effect impair effectiveness and safety of VKA, causing a need for alternative anticoagulant drugs. Recently developed anticoagulants include direct thrombin antagonists such as dabigatran or factor Xa inhibitors such as rivaroxaban, apixaban, betrixaban, and edoxaban. Currently, data from a phase III clinical trial are available for dabigatran only, which show the direct thrombin antagonist to be at least noninferior in efficacy to VKA for the prevention of stroke and systemic embolism in patients with AF. This review focuses on current advances in the development of directly acting oral anticoagulant drugs and their potential to replace the VKA class of drugs in patients with AF. (J Am Coll Cardiol 2010;56:2067-76) (C) 2010 by the American College of Cardiology Foundation",

keywords = "anticoagulants, atrial fibrillation, thrombin inhibitor, DIRECT THROMBIN INHIBITOR, FACTOR-XA INHIBITOR, RANDOMIZED CONTROLLED-TRIAL, PROTEASE-ACTIVATED RECEPTOR-1, TOTAL KNEE REPLACEMENT, NORMALIZED RATIO CONTROL, VENOUS THROMBOEMBOLISM, DABIGATRAN ETEXILATE, DOUBLE-BLIND, ORAL ANTICOAGULATION",

author = "Schirmer, {Stephan H.} and Magnus Baumhaekel and Hans-Ruprecht Neuberger and Hohnloser, {Stefan H.} and {van Gelder}, {Isabelle C.} and Lip, {Gregory Y. H.} and Michael Boehm",

year = "2010",

month = dec,

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doi = "10.1016/j.jacc.2010.09.017",

language = "English",

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pages = "2067--2076",

journal = "Journal of the American College of Cardiology",

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T1 - Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

AU - Schirmer, Stephan H.

AU - Baumhaekel, Magnus

AU - Neuberger, Hans-Ruprecht

AU - Hohnloser, Stefan H.

AU - van Gelder, Isabelle C.

AU - Lip, Gregory Y. H.

AU - Boehm, Michael

PY - 2010/12/14

Y1 - 2010/12/14

N2 - Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need of regular monitoring of its anticoagulatory effect impair effectiveness and safety of VKA, causing a need for alternative anticoagulant drugs. Recently developed anticoagulants include direct thrombin antagonists such as dabigatran or factor Xa inhibitors such as rivaroxaban, apixaban, betrixaban, and edoxaban. Currently, data from a phase III clinical trial are available for dabigatran only, which show the direct thrombin antagonist to be at least noninferior in efficacy to VKA for the prevention of stroke and systemic embolism in patients with AF. This review focuses on current advances in the development of directly acting oral anticoagulant drugs and their potential to replace the VKA class of drugs in patients with AF. (J Am Coll Cardiol 2010;56:2067-76) (C) 2010 by the American College of Cardiology Foundation

AB - Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need of regular monitoring of its anticoagulatory effect impair effectiveness and safety of VKA, causing a need for alternative anticoagulant drugs. Recently developed anticoagulants include direct thrombin antagonists such as dabigatran or factor Xa inhibitors such as rivaroxaban, apixaban, betrixaban, and edoxaban. Currently, data from a phase III clinical trial are available for dabigatran only, which show the direct thrombin antagonist to be at least noninferior in efficacy to VKA for the prevention of stroke and systemic embolism in patients with AF. This review focuses on current advances in the development of directly acting oral anticoagulant drugs and their potential to replace the VKA class of drugs in patients with AF. (J Am Coll Cardiol 2010;56:2067-76) (C) 2010 by the American College of Cardiology Foundation

KW - anticoagulants

KW - atrial fibrillation

KW - thrombin inhibitor

KW - DIRECT THROMBIN INHIBITOR

KW - FACTOR-XA INHIBITOR

KW - RANDOMIZED CONTROLLED-TRIAL

KW - PROTEASE-ACTIVATED RECEPTOR-1

KW - TOTAL KNEE REPLACEMENT

KW - NORMALIZED RATIO CONTROL

KW - VENOUS THROMBOEMBOLISM

KW - DABIGATRAN ETEXILATE

KW - DOUBLE-BLIND

KW - ORAL ANTICOAGULATION

U2 - 10.1016/j.jacc.2010.09.017

DO - 10.1016/j.jacc.2010.09.017

M3 - Review article

SN - 0735-1097

VL - 56

SP - 2067

EP - 2076

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 25

ER -

Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

Abstract

Keywords

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