title: Efficacy and safety of the target-specific oral anticoagulants for stroke prevention in atrial fibrillation: the real-life evidence.
abstract: The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF). Randomized clinical trials showed non-inferior or superior results in efficacy and safety of the TSOAs compared with warfarin for stroke prevention in NVAF patients. For this reason, the 2012 update to the European Society of Cardiology guidelines for the management of AF recommends TSOAs as broadly preferable to vitamin K antagonists (VKAs) in the vast majority of patients with NVAF [Cammet al.2012]. Although the clinical trial results and the guideline's indications, there is a need for safety and efficacy data from unselected patients in everyday clinical practice. Recently, a large number of studies testing the efficacy and the safety of TSOAs in clinical practice have been published. The aim of our article is to provide a concise review for clinicians, outlining the main studies that evaluated the efficacy and safety of TSOAs for thromboembolic stroke prevention in the real-world setting.
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Piazzale Ettore Ruggeri, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Rago
authors.affiliation: Cardiology Department, Luigi Sacco Hospital, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Proietti
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Di Meo
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Antonio Papa
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.affiliation: Department of Cardiology, Monaldi Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Onofrio
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nigro
authors.affiliation: McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: AlTurki
keywords: apixaban; atrial fibrillation; dabigatran; efficacy; novel oral anticoagulant; real life; rivaroxaban; safety; stroke