Abstract
The non–vitamin K antagonist oral anticoagulants (NOACs), such as the thrombin inhibitor
(dabigatran) and the direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban),
have been shown to be at least as efficacious and safe as conventional oral anticoagulants,
such as the vitamin K antagonists (VKAs) (e.g., warfarin), for stroke prevention in
patients with nonvalvular atrial fibrillation (NVAF). Each NOAC has various advantages
and specific features, and therefore decisions regarding appropriate stroke prevention
require individual assessment of stroke and bleeding risk on anticoagulation with
VKA therapy and NOACs when starting on any of these drugs. This review briefly describes
the results of the four NOACs clinical randomized trials and discusses how they might
impact clinical practice and choice of anticoagulants in atrial fibrillation patients.
Moreover, this review discusses the differences of the proposed management of antithrombotic
therapy in several international guidelines and pragmatic issues of NOACs for stroke
prophylaxis.
Keywords
non-VKA oral anticoagulants - vitamin K antagonist - atrial fibrillation - stroke
prevention - clinical trial