title: A practical approach to the new oral anticoagulants used for stroke prevention in patients with atrial fibrillation.
abstract: This review evaluates the research undertaken in the last six years on the use of new oral anticoagulants for stroke prevention in atrial fibrillation and provides evidence-based answers to common clinical questions. Two types of new oral anticoagulants - direct thrombin (IIa) inhibitors, and Xa inhibitors - are currently available. These drugs have similar pharmacokinetics and pharmacodynamics. They are more predictable than, though in many respects comparable to, warfarin. They do not require frequent laboratory tests, nor do they have a narrow therapeutic window. When a patient requires surgery, new oral anticoagulants are easier to manage than warfarin due to their short half-lives. Short half-lives reduce the length of bleeding events. Information obtained from risk calculators such as CHA2DS2-VASc and HAS-BLED should be considered before prescribing. New oral anticoagulants are useful in every day clinical practice, but there are complex factors that should be considered in each patient before prescribing to implement the best practice and achieve the best results.
authors.affiliation: S Bashir, Department of Cardiology, Castle Hill Hospital, Castle Rd, Cottingham, Yorkshire HU16 5JQ, UK, E-mail shaza.khider@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Bashir
authors.forename: A
authors.initials: A
authors.lastname: Al-Mohammed
authors.forename: S
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000991:Antithrombins / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D006207:Half-Life; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000991:Antithrombins; D014859:Warfarin
keywords: NOACs; atrial fibrillation; clinical practice; stroke prevention