title: Non-Vitamin K Antagonist Oral Anticoagulant Use in Patients With Atrial Fibrillation and Associated Intracranial Hemorrhage: A Focused Review.
abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia and predisposes patients to an increased risk of embolic stroke. After nearly 60 years, warfarin is no longer the only effective therapeutic option for patients with AF. Large randomized trials have consistently shown that non-vitamin K oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban significantly reduce from the risk of intracranial hemorrhage (ICH) compared with warfarin. We provide a focused review regarding the NOACs and ICH in AF patients by summarizing findings of these large clinical trials, mechanisms of lower ICH, reversal strategies with specific agents, and monitoring strategies.
authors.affiliation: Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Boris
authors.initials: B
authors.lastname: Arbit
authors.affiliation: Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Jonathan C
authors.identifier: http://orcid.org/0000-0002-1523-573X
authors.initials: JC
authors.lastname: Hsu
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D003029:Coagulants / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D003029:Coagulants; D014859:Warfarin