title: [Progress of anticoagulation therapy in atrial fibrillation].
abstract: Atrial fibrillation is currently a very prevalent disease and it represents one of the most common causes of disabling stroke. Antithrombotic therapies have reduced the incidence of this complication although they pose many limitations and difficulties. As a result, a large number of high risk patients do not receive an appropriate treatment. In recent years, four new oral anticoagulants (NOAC) with relevant advantages in comparison to vitaminK antagonists have been released. Four large phaseiii clinical trials have demonstrated that NOAC are at least as safe and efficacious as warfarin in stroke prevention in non-valve atrial fibrillation patients with moderate-high thrombotic risk, being their main advantage the reduction in intracranial hemorrhage. The arrival of these drugs has caused great expectations in the management of these patients but also new doubts. Lacking data in some subgroups of frail patients, the absence of specific antidotes available and specially their high cost represent nowadays the main limitations for their generalization.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Hernández Olmedo
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, España. Electronic address: csuarezf@salud.madrid.org.
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez Fernández
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D000069604:Dabigatran / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014859:Warfarin; D000069604:Dabigatran
keywords: Anticoagulantes de acción directa; Atrial fibrillation; Direct action anticoagulants; Fibrilación auricular; Hemorragia intracraneal; Ictus; Intracranial hemorrhage; New oral anticoagulants; Nuevos anticoagulantes orales; Stroke