Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios. in Journal of clinical medicine / J Clin Med. 2023 Sep 13;12(18):5955. doi: 10.3390/jcm12185955.
2023
AO Cuneo
AO Ordine Mauriziano
AO Cuneo
AO Ordine Mauriziano
Tipo pubblicazione
Review
Autori/Collaboratori (24)Vedi tutti...
Gelsomino S
Cardiovascular Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands.
Calvanese R
Cardiology Unit, Ospedale del Mare, 80147 Napoli, Italy.
Amico AF
Cardiovascular Prevention and Ortokinesis Clinics of Lecce, 73043 Lecce, Italy.
et alii...
Cardiovascular Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands.
Calvanese R
Cardiology Unit, Ospedale del Mare, 80147 Napoli, Italy.
Amico AF
Cardiovascular Prevention and Ortokinesis Clinics of Lecce, 73043 Lecce, Italy.
et alii...
Abstract
It is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH). In addition, many factors, such as fewer pharmacokinetic interactions and less need for monitoring, contribute to the favor of this therapeutic strategy. Although DOACs represent a more suitable option, several issues should be considered in clinical practice, including drug-drug interactions (DDIs), switching to other antithrombotic therapies, preprocedural and postprocedural periods, and the use in patients with chronic renal and liver failure and in those with cancer. Furthermore, adherence to DOACs appears to remain suboptimal. This narrative review aims to provide a practical guide for DOAC prescription and address challenging scenarios.
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PMID : 37762897
DOI : 10.3390/jcm12185955
Keywords
vitamin K antagonists (VKAs); triple antithrombotic therapy (TAT); pacemaker; obesity; non-cardiac surgery; malignancy; implantable cardioverter-defibrillator (ICD) implantation; frailty; elderly; dual antiplatelet therapy (DAPT); drug–drug interactions (DDIs); adherence; atrial fibrillation (AF); cancer; chronic kidney disease (CKD); chronic liver disease (CLD); direct oral anticoagulants (DOACs); Over-Weight Patients; Under-Weight Patients; Catheter Ablation of Atrial Fibrillation (CAAF);