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Non-vitamin K antagonist oral anticoagulants in patients with an increased risk of bleeding

The non-vitamin K antagonist oral anticoagulants (NOACs) have considerably changed clinical practice and are increasingly being used as an alternative to vitamin K antagonists (VKAs) for 3 main reasons: 1) an improved benefit-risk ratio (in particular lower rates of intracranial bleeding), 2) a more...

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Detalles Bibliográficos
Autores principales: Gremmel, Thomas, Niessner, Alexander, Domanovits, Hans, Frossard, Martin, Sengölge, Gürkan, Steinlechner, Barbara, Sycha, Thomas, Wolzt, Michael, Pabinger, Ingrid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290726/
https://www.ncbi.nlm.nih.gov/pubmed/30128955
http://dx.doi.org/10.1007/s00508-018-1381-5
Descripción
Sumario:The non-vitamin K antagonist oral anticoagulants (NOACs) have considerably changed clinical practice and are increasingly being used as an alternative to vitamin K antagonists (VKAs) for 3 main reasons: 1) an improved benefit-risk ratio (in particular lower rates of intracranial bleeding), 2) a more predictable effect without the need for routine monitoring, and 3) fewer food and drug interactions compared with VKAs. Currently, there are four NOACs available: the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban, and the thrombin inhibitor dabigatran. This consensus paper reviews the properties and usage of NOACs in a number of high-risk patient populations, such as patients with chronic kidney disease, patients ≥80 years of age and others and provides guidance for the use of NOACs in patients at risk of bleeding.