title: [The slow acceptance of new oral anticoagulants in Italy: a critical analysis of a problem].
abstract: The introduction of non-vitamin K antagonist oral anticoagulants (NOACs) into clinical practice has revolutionized the prevention and the therapeutic approaches to thromboembolic events in patients with nonvalvular atrial fibrillation and represents with no doubts one of the most remarkable advances in the history of cardiovascular medicine over the last years. NOACs beyond a comparable efficacy with vitamin K antagonists allow to overcome the limitations of this last category of drugs owing to their less drug to drug interactions and a predictable anticoagulant effect that allows a fixed dose administration without the need for continuous monitoring. However, the penetration of NOACs into the Italian market is still lower than predicted with respect to their use in other European countries.The aim of this review is to critically analyze the reasons behind this attitude through the adoption of the nominal group technique, a methodology that permits to reach an official consensus.
authors.affiliation: Divisione di Cardiologia, Ospedale Sant'Anna, Como.
authors.forename: Giovanni Luca
authors.initials: GL
authors.lastname: Botto
authors.affiliation: U.O. Cardiologia, Fondazione Poliambulanza, Istituto Ospedaliero di Brescia, Brescia.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cuccia
authors.affiliation: Dipartimento Cardiovascolare, IRCSS Multimedica, Sesto San Giovanni (MI).
authors.forename: Edoardo
authors.initials: E
authors.lastname: Gronda
authors.affiliation: U.O.C. Malattie Cardiovascolari, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Università degli Studi, Milano.
authors.forename: Federico
authors.initials: F
authors.lastname: Lombardi
authors.affiliation: Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lunati
authors.affiliation: U.O.C. Malattie Cardiovascolari, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Università degli Studi, Milano.
authors.forename: Antonio
authors.initials: A
authors.lastname: Maggi
authors.affiliation: U.O.C. Malattie Cardiovascolari, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Università degli Studi, Milano.
authors.forename: Ferdinando Maria
authors.initials: FM
authors.lastname: Massari
authors.affiliation: S.C. Cardiologia, Ospedale Santa Croce e Carle, Cuneo.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.affiliation: Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.affiliation: S.C. Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia.
authors.forename: Luigi Oltrona
authors.initials: LO
authors.lastname: Visconti
authors.affiliation: Cardiologia, Istituto Clinico S. Anna, Brescia.
authors.forename: Cesare
authors.initials: C
authors.lastname: Proto
authors.affiliation: U.O. Cardiologia, Istituto Clinico Sant'Ambrogio, Milano.
authors.forename: Enrico
authors.initials: E
authors.lastname: Pusineri
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università dell'Insubria, Varese.
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation; D001291:Attitude of Health Personnel; D004363:Drug Utilization; D006801:Humans; D007558:Italy; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000925:Anticoagulants