| Autor: |
Székely O; a Institute of Cardiovascular Sciences , University of Birmingham , Birmingham , UK., Miyazawa K; a Institute of Cardiovascular Sciences , University of Birmingham , Birmingham , UK., Lip GYH; a Institute of Cardiovascular Sciences , University of Birmingham , Birmingham , UK.; b Liverpool Centre for Cardiovascular Science , University of Liverpool and Liverpool Heart & Chest Hospital , Liverpool , UK.; c Aalborg Thrombosis Research Unit , Aalborg University , Aalborg , Denmark. |
| Jazyk: |
angličtina |
| Zdroj: |
Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2018 Dec; Vol. 19 (18), pp. 1999-2009. Date of Electronic Publication: 2018 Oct 25. |
| DOI: |
10.1080/14656566.2018.1537368 |
| Abstrakt: |
Introduction : Atrial fibrillation (AF) is associated with high morbidity and mortality rates due to thromboembolic complications, and anticoagulation is central to the management of this common arrhythmia to prevent acute thromboembolic events. The traditional anticoagulants: heparin, fondaparinux, and vitamin K antagonists (VKA, e.g. warfarin, acenocoumarol or phenprocoumin) have long served as pharmacotherapy for ischemic stroke prophylaxis. Areas covered : In this review article, the authors provide an overview on current and emerging pharmacotherapy for ischemic stroke prevention. Furthermore, they review the data from novel therapeutic targets in the coagulation cascade, and investigational anticoagulant drugs currently assessed in preclinical and clinical studies. Expert opinion : The introduction of nonvitamin K antagonist oral anticoagulants (NOACs) was an important milestone, as these drugs show relative efficacy, safety, and convenience compared to the VKAs. Nevertheless, their clinical use still has some limitations with, for example, patients with severe renal impairment and those with mechanical heart valves, high bleeding risks, lack of standard laboratory monitoring and (some) reversal agents. To overcome some of these limitations, various attempts are now underway to discover new strategies and targets via the hemostatic pathway in order to develop new coagulation inhibiting drugs. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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