New frontiers in anticoagulation: non vitamin-K oral anticoagulants in stroke prevention. (3rd June 2017)

• Record Type: Journal Article
• Authors: Arnao, Valentina; Riolo, Marianna; Tuttolomondo, Antonino; Pinto, Antonio; Fierro, Brigida; Aridon, Paolo
• Is Part Of: Expert review of neurotherapeutics. Volume 17:Number 6(2017)
• Page Start: 539
• Page End: 552
• Publication Date: 2017-06-03
• Subjects: Anticoagulation -- atrial fibrillation -- measure of monitoring -- stroke prevention -- reverse therapy -- non vitamin-K oral anticoagulants -- warfarin -- aspirin; Neuropharmacology -- Periodicals; 615.7805
• DOI: 10.1080/14737175.2017.1268053
• Languages: English
• ISSNs: 1473-7175

Abstract

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.