Focused Update of Guidelines for Antithrombotic Management of Patients with Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack
Journal of the Korean Neurological Association
;
: 184-192, 2016.
Article
in Korean
| WPRIM
| ID: wpr-65871
ABSTRACT
Cardioembolic stroke related to atrial fibrillation is problematic due to high recurrence, mortality, and morbidity rates. The optimal anticoagulant therapy therefore needs to be applied to prevent the occurrence of a second stroke in patients with nonvalvular atrial fibrillation. The oral anticoagulant warfarin has traditionally been used, but it is limited by its narrow efficacy window, complex pharmacokinetics, and multiple drug interactions, thus requiring frequent blood monitoring. New oral anticoagulants have recently been developed that target a specific coagulation component. Dabigatran (a direct thrombin inhibitor) and rivaroxaban, apixaban, and edoxaban (inhibitors of factor Xa) have advantages of rapid action time, short half-life, stable plasma concentration, and few drug interactions. Large randomized clinical trials and meta-analyses have recently been published on the efficacy and safety of these new oral anticoagulants. Based on the results obtained in recent clinical trials, we have revised the recommendations for selecting optimal anticoagulant therapy in patients with nonvalvular atrial fibrillation.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Plasma
/
Recurrence
/
Atrial Fibrillation
/
Warfarin
/
Pharmacokinetics
/
Thrombin
/
Ischemic Attack, Transient
/
Mortality
/
Stroke
/
Drug Interactions
Type of study:
Controlled clinical trial
/
Practice guideline
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Neurological Association
Year:
2016
Type:
Article
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