A REVIEW ON A COMPARATIVE STUDY ON EFFECTIVENESS AND SAFETY OF NOVEL ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION

P. K, M. George, L. Joseph
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Abstract

Atrial fibrillation (AF) is characterized as an extremely rapid and disorganized atrial activation. These irregular heartbeats will cause blood to collect within the heart and potentially form a clot, which can travel to a person’s brain and cause a stroke. AF increases stroke risk by 3 to 5 fold. Vitamin K antagonists (VKAs) are highly effective for the prevention of stroke, mainly of ischemic origin, in patients with AF. For this reason, VKAs are currently recommended in all AF patients at moderate to high risk for stroke or systemic embolism (SSE). VKAs have significant limitations, particularly their unpredictable anticoagulant response and numerous food and drug interactions, mandating regular laboratory monitoring. These limitations make treatment with VKAs problematic for many patients; as a result, only about half of all potentially eligible AF patients are treated with VKAs. Over the last several years, novel oral anticoagulant drugs (NOACs), including direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (apixaban & rivaroxaban), have been developed. New orally administered anticoagulant drugs have emerged as potential alternatives to VKAs for the prevention of ischaemic stroke or systemic embolism in patients with chronic atrial fibrillation. Novel oral anticoagulants (NOACs), due to their a lot of predictable therapeutic result and more favorable haemorrhagic risk profile, represent a particularly attractive therapeutic option in AF patients. Keywords:  Novel oral anticoagulants (NOACs), Vitamin K antagonist (VKAs), Atrial fibrillation, Apixaban, Dabigatran, Rivaroxaban.
新型口服抗凝剂治疗心房颤动的有效性和安全性比较研究综述
心房颤动(AF)的特点是一种极其迅速和无组织的心房激活。这些不规则的心跳会导致血液在心脏内聚集,并可能形成凝块,凝块会进入人的大脑,导致中风。房颤使中风风险增加3 - 5倍。维生素K拮抗剂(VKAs)对房颤患者预防卒中(主要是缺血性卒中)非常有效。因此,目前推荐所有中度至高风险卒中或全身性栓塞(SSE)的房颤患者使用VKAs。vka具有明显的局限性,特别是其不可预测的抗凝反应和大量的食品和药物相互作用,需要定期进行实验室监测。这些限制使得许多患者使用vka治疗存在问题;因此,在所有可能符合条件的房颤患者中,只有大约一半接受了vka治疗。在过去的几年里,新型口服抗凝药物(NOACs),包括直接凝血酶抑制剂(达比加群)和Xa因子抑制剂(阿哌沙班和利伐沙班)已经被开发出来。新的口服抗凝药物已成为预防慢性房颤患者缺血性卒中或全身性栓塞的潜在替代vka。新型口服抗凝剂(NOACs)由于其可预测的治疗效果和更有利的出血风险特征,成为AF患者特别有吸引力的治疗选择。关键词:新型口服抗凝剂,维生素K拮抗剂,房颤,阿哌沙班,达比加群,利伐沙班
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