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Sökning: onr:"swepub:oai:DiVA.org:uu-300322" > Oral anticoagulants...

Oral anticoagulants in coronary heart disease (Section IV) Position paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease

De Caterina, Raffaele (författare)
Univ G DAnnunzio, Chieti, Italy.;Fdn Toscana G Monasterio, Pisa, Italy.
Husted, Steen (författare)
Univ Aarhus, Aarhus, Denmark.
Wallentin, Lars (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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Andreotti, Felicita (författare)
Univ Cattolica Sacro Cuore, I-00168 Rome, Italy.
Arnesen, Harald (författare)
Oslo Univ Hosp Ulleval, Oslo, Norway.;Univ Oslo, Oslo, Norway.
Bachmann, Fedor (författare)
Univ Lausanne, Lausanne, Switzerland.
Baigent, Colin (författare)
Univ Oxford, Oxford, England.
Collet, Jean-Philippe (författare)
Grp Hosp Pitie Salpetriere, INSERM, UMRS ICAN 1166, F-75634 Paris, France.
Halvorsen, Sigrun (författare)
Oslo Univ Hosp Ulleval, Oslo, Norway.;Univ Oslo, Oslo, Norway.
Huber, Kurt (författare)
Wilhelminenhosp, Vienna, Austria.
Jespersen, Jorgen (författare)
Univ Southern Denmark, Esbjerg, Denmark.
Kristensen, Steen Dalby (författare)
Aarhus Univ Hosp, DK-8000 Aarhus, Denmark.
Lip, Gregory Y. H. (författare)
Univ Birmingham, City Hosp, Inst Cardiovasc Sci, Birmingham, W Midlands, England.
Morais, Joao (författare)
Hosp Santo Andre, Leiria, Portugal.
Rasmussen, Lars Hvilsted (författare)
Aalborg Univ, Aalborg, Denmark.
Ricci, Fabrizio (författare)
Univ G DAnnunzio, Chieti, Italy.;Fdn Toscana G Monasterio, Pisa, Italy.
Sibbing, Dirk (författare)
Univ Munich, Klinikum Univ Munchen, Med Klin & Poliklin 1, Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany.
Siegbahn, Agneta (författare)
Uppsala universitet,Koagulation och inflammationsvetenskap
Storey, Robert F. (författare)
Univ Sheffield, Sheffield, S Yorkshire, England.
ten Berg, Jurrien (författare)
St Antonius Hosp, Nieuwegein, Netherlands.
Verheugt, Freek W. A. (författare)
Onze Lieve Vrouw Hosp, Amsterdam, Netherlands.
Weitz, Jeffrey I. (författare)
McMaster Univ, Hamilton, ON, Canada.;Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada.
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Univ G DAnnunzio, Chieti, Italy;Fdn Toscana G Monasterio, Pisa, Italy. Univ Aarhus, Aarhus, Denmark. (creator_code:org_t)
2016
2016
Engelska.
Ingår i: Thrombosis and Haemostasis. - 0340-6245. ; 115:4, s. 685-711
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Until recently, vitamin K antagonists (VKAs) were the only available oral anticoagulants evaluated for long-term treatment of patients with coronary heart disease (CHD), particularly after an acute coronary syndrome (ACS). Despite efficacy in this setting, VKAs are rarely used because they are cumbersome to administer. Instead, the more readily manageable antiplatelet agents are the mainstay of prevention in ACS patients. This situation has the potential to change with the introduction of non-VKA oral anticoagulants (NOACs), which are easier to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring. The NOACs include dabigatran, which inhibits thrombin, and apixaban, rivaroxaban and edoxaban, which inhibit factor Xa. Apixaban and rivaroxaban were evaluated in phase III trials for prevention of recurrent ischaemia in ACS patients, most of whom were also receiving dual antiplatelet therapy with aspirin and clopidogrel. Although at the doses tested rivaroxaban was effective and apixaban was not, both agents increased major bleeding. The role for the NOACs in ACS management, although promising, is therefore complicated, because it is uncertain how they compare with newer antiplatelet agents, such as prasugrel, ticagrelor or vorapaxar, and because their safety in combination with these other drugs is unknown. Ongoing studies are also now evaluating the use of NOACs in non-valvular atrial fibrillation patients, where their role is established, with coexistent ACS or coronary stenting. Focusing on CHD, we review the results of clinical trials with the NOACs and provide a perspective on their future incorporation into clinical practice.

Ämnesord

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Anticoagulants
vitamin K antagonists
non-vitamin K antagonist oral anticoagulants
dabigatran etexilate
rivaroxaban
apixaban
edoxaban
coronary heart disease
acute coronary syndrome

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