Antithrombotic alternatives for stroke prevention in atrial fibrillation: critical differences and remaining questions
Open Access
- 16 April 2013
- journal article
- Published by BioExcel in Drugs in Context
- Vol. 2013, 1-6
- https://doi.org/10.7573/dic.212251
Abstract
Three therapeutic alternatives for prevention of stroke in patients with atrial fibrillation are available in dabigatran (an oral direct thrombin inhibitor), rivaroxaban, and apixaban (both oral blood coagulation factor Xa inhibitors). Compared with warfarin, these new agents have a more predictable pharmacodynamic response and fewer major clinically relevant drug–drug interactions. These agents also have few, if any, food–drug interactions, and infrequent or no need for routine laboratory monitoring. These agents also bring new disadvantages, particularly lack of clearly defined reversal strategies, inability to effectively monitor patient response, and higher cost. Selection of the most appropriate oral antithrombotic agent for a given patient is dependent on clinician knowledge of the similarities and critical differences between the available antithrombotic medicationsKeywords
This publication has 20 references indexed in Scilit:
- Treatment of Dabigatran-Associated BleedingJournal of Pharmacy Practice, 2012
- Cost-effectiveness of apixaban vs warfarin for secondary stroke prevention in atrial fibrillationNeurology, 2012
- Cost–Effectiveness of Rivaroxaban Compared to Warfarin for Stroke Prevention in Atrial FibrillationThe American Journal of Cardiology, 2012
- Newer oral anticoagulants: A review of laboratory monitoring options and reversal agents in the hemorrhagic patientAmerican Journal of Health-System Pharmacy, 2012
- Evaluation of Prothrombin Complex Concentrate and Recombinant Activated Factor VII to Reverse Rivaroxaban in a Rabbit ModelAnesthesiology, 2012
- Hemostatic Therapy in Experimental Intracerebral Hemorrhage Associated With the Direct Thrombin Inhibitor DabigatranStroke, 2011
- Apixaban in Patients with Atrial FibrillationThe New England Journal of Medicine, 2011
- Cost-Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Atrial FibrillationAnnals of Internal Medicine, 2011
- Influence of Renal Impairment on the Pharmacokinetics and Pharmacodynamics of Oral Dabigatran EtexilateClinical Pharmacokinetics, 2010
- Validation of Clinical Classification Schemes for Predicting StrokeJama-Journal Of The American Medical Association, 2001