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.

Luca, F., Oliva, F., Abrignani, M., Di Fusco, S., Parrini, I., Canale, M., et al. (2023). Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios. JOURNAL OF CLINICAL MEDICINE, 12(18) [10.3390/jcm12185955].

Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Oliva F.;Maloberti A.;
2023

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.
Articolo in rivista - Articolo scientifico
adherence; atrial fibrillation (AF); cancer; Catheter Ablation of Atrial Fibrillation (CAAF); chronic kidney disease (CKD); chronic liver disease (CLD); direct oral anticoagulants (DOACs); drug–drug interactions (DDIs); dual antiplatelet therapy (DAPT); elderly; frailty; implantable cardioverter-defibrillator (ICD) implantation; malignancy; non-cardiac surgery; obesity; Over-Weight Patients; pacemaker; triple antithrombotic therapy (TAT); Under-Weight Patients; vitamin K antagonists (VKAs);
English
13-set-2023
2023
12
18
5955
none
Luca, F., Oliva, F., Abrignani, M., Di Fusco, S., Parrini, I., Canale, M., et al. (2023). Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios. JOURNAL OF CLINICAL MEDICINE, 12(18) [10.3390/jcm12185955].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/452983
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