title: [Novel oral anticoagulants: more opportunities or more risks? And for which patients?].
abstract: Novel direct oral anticoagulants (NAO) represent an innovative and potentially relevant option for the prevention of cardiac embolism in patients with atrial fibrillation. Their recent introduction has been followed by a wide debate on their appropriate use, considering that they do not require regular monitoring of INR values as Vitamin K Antagonists (VKA) do, but that are much less tested in everyday clinical practice and much more expensive than VKA. Starting from the quite favourable results of the available RCTs - showing that NAO are at least non-inferior to VKA and that may be even better for some outcomes - this article discusses the clinical relevance of these results, their transferability into clinical practice looking at the methods of those RCTs and potential risks related to their widespread introduction. Final considerations on possible strategies for their appropriate and progressive introduction are also provided, using the experience developing in the Emilia-Romagna region.
authors.forename: Marco
authors.initials: M
authors.lastname: Marietta
authors.forename: Giulio
authors.initials: G
authors.lastname: Formoso
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Marata
authors.forename: Emilio
authors.initials: E
authors.lastname: Maestri
authors.forename: Nicola
authors.initials: N
authors.lastname: Magrini
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D016903:Drug Monitoring / Q000379:methods; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D019934:International Normalized Ratio; D016032:Randomized Controlled Trials as Topic
chemical_list: D000925:Anticoagulants