TY - JOUR AU - Polzin, Amin; Dannenberg, Lisa; Thienel, Manuela; Orban, Martin; Wolff, Georg; Hohlfeld, Thomas; Zeus, Tobias; Kelm, Malte; Petzold, Tobias TI - Noncanonical Effects of Oral Thrombin and Factor Xa Inhibitors in Platelet Activation and Arterial Thrombosis SN - 0340-6245 SN - 2567-689X PY - 2020 JO - Thromb Haemost JF - Thrombosis and Haemostasis LA - EN VL - 121 IS - 02 SP - 122 EP - 130 DA - 2020/09/17 KW - anticoagulation KW - anticoagulants KW - myocardial infarction KW - platelet aggregation AB - Nonvitamin K oral anticoagulants (NOACs) or direct oral anticoagulants comprise inhibitors of factor Xa (rivaroxaban, apixaban, edoxaban) or factor IIa (dabigatran). Both classes efficiently interfere with the final or penultimate step of the coagulation cascade and showed superior net clinical benefit compared with vitamin K antagonists for prevention of thromboembolic events in patients with AF and for prevention and therapy of deep vein thrombosis and pulmonary embolism. None the less, accumulating data suggested, that there may be differences regarding the frequency of atherothrombotic cardiovascular events between NOACs. Thus, the optimal individualized NOAC for each patient remains a matter of debate. Against this background, some basic and translational analyses emphasized NOAC effects that impact on platelet activity and arterial thrombus formation beyond inhibition of plasmatic coagulation. In this review, we will provide an overview of the available clinical and translational evidence for so-called noncanonical NOAC effects on platelet activation and arterial thrombosis. PB - Georg Thieme Verlag KG DO - 10.1055/s-0040-1716750 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1716750 ER -