title: New frontiers in anticoagulation: non vitamin-K oral anticoagulants in stroke prevention.
abstract: Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists. New evidences have suggested their use in treatment of elderly people, in patients with renal insufficiency or with antiphospholipid antibody syndrome. In addition, the use of antidotes, which rapidly reverse the anticoagulant effect of the NOACs, could be useful in bleeding, during emergency procedures, or in case of overdose.
authors.affiliation: a BioNeC Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche , Università degli Studi di Palermo , Palermo , Italy.|b Biomedical Department of Internal and Specialistic Medicine (Di.Bi.M.I.S), School of Medicina Clinica e Scienze del Comportamento , University of Palermo , Palermo , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Arnao
authors.affiliation: a BioNeC Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche , Università degli Studi di Palermo , Palermo , Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Riolo
authors.affiliation: c Biomedical Department of Internal and Specialistic Medicine (Di.Bi.M.I.S) , University of Palermo , Palermo , Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Tuttolomondo
authors.affiliation: c Biomedical Department of Internal and Specialistic Medicine (Di.Bi.M.I.S) , University of Palermo , Palermo , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.affiliation: a BioNeC Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche , Università degli Studi di Palermo , Palermo , Italy.
authors.forename: Brigida
authors.initials: B
authors.lastname: Fierro
authors.affiliation: a BioNeC Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche , Università degli Studi di Palermo , Palermo , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Aridon
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D011720:Pyrazoles; D011728:Pyridones; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014812:Vitamin K
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; D014812:Vitamin K; C522181:apixaban
keywords: Anticoagulation; aspirin; atrial fibrillation; measure of monitoring; non vitamin-K oral anticoagulants; reverse therapy; stroke prevention; warfarin