Dose issue of novel oral anticoagulants to prevent stroke in patients with atrial fibrillation / 国际脑血管病杂志

ABSTRACT

Oral anticoagulants are important for preventing stroke in patients with atrial fibrillation.Compared with the traditional oral anticoagulant warfarin,the novel oral anticoagulants (NOACs) have the characteristics of high efficiency,safety,and no need to monitor coagulation function.However,current clinical reports have showed that the dose is usually low when NOACs were used for preventing stroke in patients with atrial fibrillation.Its main reason may be associated with the risk avoidance and the difference in doctor and patient preferences.The analysis from the aspects of safety and effectiveness,the risk of ischemic stroke or systemic embolism is lower when the dose of NOACs is relatively high,and the risk of hemorrhage is lower when the dose of NOACs is relatively lower.Given the differences between the incidences of different events,the disability rate and the mortality rate,the patient with atrial fibrillation are more suitable for using high-dose drug.When choosing a specific dose,taking into account the specificity,the appropriate dose,intensity,and dosing regimen should be given according to the guideline recommendations,appropriate reference to renal function and patient preferences,and individual differences in order to obtain the best clinical efficacy..