title: The king is dead (warfarin): direct thrombin and factor Xa inhibitors: the next Diadochian War?
abstract: Atrial fibrillation is an important risk factor for stroke. New drugs for oral anticoagulation that do not exhibit the limitations of vitamin K antagonists like warfarin are under investigation. These include direct factor Xa inhibitors and direct thrombin-inhibitors. Recent studies provide promising results for apixaban, dabigatran, and rivaroxaban, including higher efficacy and significantly lower incidences of intracranial bleeds compared with warfarin. The new oral anticoagulants substances show similar results in secondary as in primary stroke prevention in patients with AF and will on the long run replace warfarin.
authors.affiliation: Department of Neurology, University Hospital Essen, Germany. h.diener@uni-essen.de
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.forename: John
authors.initials: J
authors.lastname: Eikelboom
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
authors.forename: Werner
authors.initials: W
authors.lastname: Hacke
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology; D001562:Benzimidazoles; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology; D000069604:Dabigatran; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000517:prevention & control; D013917:Thrombin / Q000037:antagonists & inhibitors*; D014859:Warfarin / Q000627:therapeutic use*; D015091:beta-Alanine / Q000031:analogs & derivatives
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D015091:beta-Alanine; D014859:Warfarin; D013917:Thrombin; D000069604:Dabigatran