New oral anticoagulants

ABSTRACT

The most important and widely-prescribed drug for anticoagulation is a vitamin K antagonist such as warfarin although it has several limitations in clinical use. New oral anticoagulants (NOACs) have been developed to overcome these problems. The clinical efficacy and safety of dabigatran, rivaroxaban, and apixaban have been shown to be superior to warfarin through large-scale clinical trials. These NOACs can replace warfarin in significant proportions of patients with non-valvular atrial fibrillation to prevent stroke. Recent management guidelines for atrial fibrillation have already recommended NOACs for stroke prevention instead of warfarin. Future clinical studies should resolve the limitations of NOACs and try to extend their clinical indications.