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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ther+Clin+Risk+Manag
2015 ; 11
(ä): 967-77
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
New oral anticoagulants: their advantages and disadvantages compared with vitamin
K antagonists in the prevention and treatment of patients with thromboembolic
events
#MMPMID26150723
Mekaj YH
; Mekaj AY
; Duci SB
; Miftari EI
Ther Clin Risk Manag
2015[]; 11
(ä): 967-77
PMID26150723
show ga
Despite the discovery and application of many parenteral (unfractionated and
low-molecular-weight heparins) and oral anticoagulant vitamin K antagonist (VKA)
drugs, the prevention and treatment of venous and arterial thrombotic phenomena
remain major medical challenges. Furthermore, VKAs are the only oral
anticoagulants used during the past 60 years. The main objective of this study is
to present recent data on non-vitamin K antagonist oral anticoagulants (NOACs)
and to analyze their advantages and disadvantages compared with those of VKAs
based on a large number of recent studies. NOACs are novel direct-acting
medications that are selective for one specific coagulation factor, either
thrombin (IIa) or activated factor X (Xa). Several NOACs, such as dabigatran (a
direct inhibitor of FIIa) and rivaroxaban, apixaban and edoxaban (direct
inhibitors of factor Xa), have been used for at least 5 years but possibly 10
years. Unlike traditional VKAs, which prevent the coagulation process by
suppressing the synthesis of vitamin K-dependent factors, NOACs directly inhibit
key proteases (factors IIa and Xa). The important indications of these drugs are
the prevention and treatment of deep vein thrombosis and pulmonary embolisms, and
the prevention of atherothrombotic events in the heart and brain of patients with
acute coronary syndrome and atrial fibrillation. They are not fixed, and
dose-various strengths are available. Most studies have reported that more
advantages than disadvantages for NOACs when compared with VKAs, with the most
important advantages of NOACs including safety issues (ie, a lower incidence of
major bleeding), convenience of use, minor drug and food interactions, a wide
therapeutic window, and no need for laboratory monitoring. Nonetheless, there are
some conditions for which VKAs remain the drug of choice. Based on the available
data, we can conclude that NOACs have greater advantages and fewer disadvantages
compared with VKAs. New studies are required to further assess the efficacy of
NOACs.