title: The Role of Nonvitamin K Antagonist Oral Anticoagulants (NOACs) in Stroke Prevention in Patients with Atrial Fibrillation.
abstract: Anticoagulation is important in stroke prevention in patients with atrial fibrillation. Until recently, heparins and vitamin K antagonists were the only available therapy for stroke reduction in atrial fibrillation (AF) patients. Non-vitamin K antagonist oral anticoagulants (NOACs) including direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are now available and offer new options for stroke prevention. This article reviews the available data on the use of NOACs for primary and secondary stroke prevention in AF patients and describes specific patient populations to guide clinician in making the informed decision regarding appropriate use of those agents. It also addresses the use of NOACs early after acute stroke and use of thrombolysis while on NOAC.
authors.affiliation: Cardiology Fellow, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Sofya
authors.initials: S
authors.lastname: Kuznetsov
authors.affiliation: Department of Pharmacy, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Barcelona
authors.affiliation: Division of Cardiovascular Medicine, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue - LKS 5038, Cleveland, OH, 44106, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Josephson
authors.affiliation: Division of Cardiovascular Medicine, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue - LKS 5038, Cleveland, OH, 44106, USA. SriKrishna.MadanMohan@UHhospitals.org.
authors.forename: Sri K Madan
authors.initials: SK
authors.lastname: Mohan
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors / Q000627:therapeutic use; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications; D020521:Stroke / Q000150:complications / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors
keywords: Acute stroke; Intracranial hemorrhage (ICH); Nonvalvular atrial fibrillation (AVAF); Nonvitamin K antagonist oral anticoagulants (NOACs); Secondary stroke prevention; Thrombolysis