Choosing the optimal oral anticoagulant for stroke prevention in atrial fibrillation: direct oral anticoagulants vs vitamin K antagonists.

IF 5.5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis Pub Date : 2024-11-23 DOI:10.1016/j.jtha.2024.11.005

Stephanie Carlin, Noel Chan, Alejandro Godoy, Vinai Bhagirath, Jack Hirsh, John Eikelboom

引用次数: 0

Abstract

Direct oral anticoagulants (DOACs) have replaced vitamin K antagonists (VKAs) for stroke prevention in many patients with atrial fibrillation, but VKAs may still be preferred in some situations. We use a case-based approach to present the evidence for the possible use of a VKA in preference to a DOAC in patients with atrial fibrillation and rheumatic mitral stenosis, high body mass index, frailty, and breakthrough stroke despite being prescribed a DOAC.

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JTH in Clinic - 为预防心房颤动中风选择最佳口服抗凝剂：直接口服抗凝剂与维生素 K 拮抗剂。

直接口服抗凝剂 (DOAC) 已取代维生素 K 拮抗剂 (VKA)，用于许多心房颤动 (AF) 患者的中风预防，但在某些情况下，VKA 可能仍是首选。我们采用基于病例的方法，介绍了在心房颤动合并风湿性二尖瓣狭窄、高体重指数、体弱以及虽已处方 DOAC 但仍有突破性卒中的患者中，VKA 可能比 DOAC 更受青睐的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Thrombosis and Haemostasis 医学-外周血管病

CiteScore

24.30

自引率

3.80%

发文量

321

审稿时长

1 months

期刊介绍： The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.