Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

01-11-2013 | Review Article | Uitgave 11/2013 Open Access

Netherlands Heart Journal 11/2013

The new oral anticoagulants in atrial fibrillation: an update

Tijdschrift:
Netherlands Heart Journal > Uitgave 11/2013
Auteur:
F. W. A. Verheugt

Abstract

In patients with nonvalvular atrial fibrillation, oral anticoagulation with the vitamin K antagonists acenocoumarol, phenprocoumon and warfarin reduces the risk of stroke by more than 60 %, whereas single or double antiplatelet therapy is much less effective and sometimes associated with a similar bleeding risk as vitamin K antagonists. Besides bleeding, and intracranial haemorrhage in particular, INR monitoring remains the largest drawback of vitamin K antagonists. In the last decade oral agents have been developed that directly block the activity of thrombin (factor IIa), as well as drugs that directly inhibit activated factor X (Xa), which is the first compound in the final common pathway to the activation of thrombin. These agents have been approved for stroke prevention in atrial fibrillation and are now reimbursed under a national guideline for their safe use. They have advantages in that they do not need monitoring and have a fast onset and offset of action, but lack an established specific antidote. This survey addresses the role of modern anticoagulation for stroke prevention in atrial fibrillation.

Onze productaanbevelingen

Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
Over dit artikel

Andere artikelen Uitgave 11/2013

Netherlands Heart Journal 11/2013 Naar de uitgave

Editorial Comment

The haemodynamic cascade