CASE REPORT
New oral anticoagulants in the prevention of stroke
Publication date: 2013-10-25
Medical Studies 2013;29(3):264-266
KEYWORDS
ABSTRACT
Atrial fibrillation is associated with a few folds higher risk of stroke. Traditional vitamin K antagonists used in the prevention of stroke in patients with non-valvular atrial fibrillation are often not efficient enough due to their interactions with a broad range of substances including medicines or food ingridients and problems with monitoring the treatment. New oral anticoagulants pose an alternative for the vitamin K antagonists. They are equally efficient in the prevention of stroke, but are safer and have no requirement for routine coagulation monitoring. We present a case of a patient with atrial fibrillation, high risk of tromboembolism and recurring episodes of hemorrhages. Considering the possible complications, rivaroxaban was administered.
REFERENCES (20)
1.
The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC): 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2012; 33: 2719–2747.
2.
Camm AJ, Kirchof P, Lip G, et al. Wytyczne dotyczące postępowania u chorych z migotaniem przedsionków. Kardiol Pol 2010; 68 supl. VII: 487–566.
3.
Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991; 22: 983–988.
4.
Albers GW, Yim JM, Belew KM, et al. Status of antithrombotic therapy for patients with atrial fibrillation in university hospitals. Arch Intern Med 1996; 156: 2311–2316.
5.
Go AS, Hylek EM, Borowsky LH, et al. Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. Ann Intern Med 1999; 131: 927–934.
6.
Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883–891.
7.
Kołcz M, Bała M, Jaeschke R. Czy u chorych z niezastawkowym migotaniem przedsionków rywaroksaban jest równie skuteczny jak warfaryna w zmniejszaniu ryzyka udaru mózgu i zatoru systemowego? Med Prakt 2012; 2: 71–77.
8.
Rose AJ, Hylek EM, Ozonoff A, et al. Risk-adjusted percent time in therapeutic range as a quality indicator for outpatient oral anticoagulation: results of the Veterans Affairs Study to Improve Anticoagulation (VARIA). Circ Cardiovasc Qual Outcomes 2011; 4: 22–29.
9.
Cohen N, Almoznino-Sarafian D, Alon I, et al. Warfarin stroke prevention still underused in atrial fibrillation: patterns of omission. Stroke 2000; 31: 1217–1222.
10.
Porębska A, Nowacki P. Migotanie przedsionków jako istotny czynnik ryzyka udaru niedokrwiennego mózgu. Neurol Neurochir Pol 2005; 39: 134–140.
11.
Scott PA, Pancioli AM, Davis LA, et al. Prevalence of atrial fibrillation and antithrombotic prophylaxis in emergency department patients. Stroke 2002; 33: 2664–2669.
12.
Undas A. Trudne problemy terapeutyczne u chorych leczonych doustnymi antykoagulantami z grupy antagonistów antywitaminy K. J Transf Med 2011; 4: 185–192.
13.
Deplanque D, Leys D, Parnetti L, et al. Stroke prevention and atrial fibrillation: reasons leading to an inappropriate management. Main results of the SAFE II study. Br J Clin Pharmacol 2004; 57: 798–806.
14.
Pradhan AA, Levine MA. Warfarin use in atrial fibrillation: A random sample survey of family physician beliefs and preferences. Can J Clin Pharmacol 2002; 9: 199–202.
15.
Kubitza D, Becka M, Wensing G, et al. Safety, pharmacodynamics, and pharmacokinetics of BAY 59-7939: an oral, direct Factor Xa inhibitor – after multiple dosing in healthy male subjects. Eur J Clin Pharmacol 2005; 61: 873–880.
16.
Kubitza D, Becka M, Roth A, Mueck W. Dose-escalation study of the pharmacokinetics and pharmacodynamics of rivaroxaban in healthy elderly subjects. Curr Med Res Opin 2008; 24: 2757–2765.
17.
Eriksson BI, Borris LC, Dahl OE, et al. Novel oral factor Xa and thrombin inhibitors in the management of thromboembolism. Annu Rev Med 2011; 62: 41–57.
18.
ROCKET AF Study Investigators: Rivaroxaban-once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: rationale and design of the ROCKET AF study. Am Heart J 2010; 159: 340–347.
20.
Sellam J, Costedoat-Chalumeau N, Amoura Z. Potentiation of fluindione or warfarin by dexamethasone in multiple myeloma and AL amyloidosis. Joint Bone Spine 2007; 74: 446-452.
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| ISSN: | 1899-1874 |
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