title: [The role of new oral anticoagulants in cerebrovascular diseases].
abstract: Cardioembolisation is responsible for 20 percent of ischaemic stroke cases, which most commonly derives from non-valvular atrial fibrillation. Although warfarin is highly effective in primary and secondary stroke prevention, its use is limited by the high risk of haemorrhagic complications and a narrow therapeutic range that needs regular monitoring of INR. These limitations explained the strong need for developing new oral anticoagulants. The so-called 'new oral anticoagulants' are trying to find new targets for modifying the coagulation cascade. Apixaban, edoxaban and rivaroxaban are direct factor Xa inhibitors, while dabigatran works as a direct thrombin inhibitor. Recent phase-III clinical trials proved their effectiveness in stroke prevention and risk reducing of haemorrhagic events as well, so they can already be found as recommended drugs in new guidelines of European and American societies of cardiology and stroke. The use of new oral anticoagulants instead of warfarin in patients with atrial fibrillation or as a secondary prevention after cardioembolic stroke has to be considered.
authors.affiliation: Semmelweis University Department of Neurology, Budapest, Hungary. orosz.peter@med.semmelweis-univ.hu.
authors.forename: Péter
authors.initials: P
authors.lastname: Orosz
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D002986:Clinical Trials as Topic; D006801:Humans; D020300:Intracranial Hemorrhages / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D055502:Secondary Prevention / Q000379:methods
chemical_list: D000925:Anticoagulants