Abstract
Atrial fibrillation (AF) is characterized as an extremely rapid and disorganized atrial activation. These irregular heartbeats will cause blood to collect within the heart and potentially form a clot, which can travel to a person’s brain and cause a stroke. AF increases stroke risk by 3 to 5 fold. Vitamin K antagonists (VKAs) are highly effective for the prevention of stroke, mainly of ischemic origin, in patients with AF. For this reason, VKAs are currently recommended in all AF patients at moderate to high risk for stroke or systemic embolism (SSE). VKAs have significant limitations, particularly their unpredictable anticoagulant response and numerous food and drug interactions, mandating regular laboratory monitoring. These limitations make treatment with VKAs problematic for many patients; as a result, only about half of all potentially eligible AF patients are treated with VKAs. Over the last several years, novel oral anticoagulant drugs (NOACs), including direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (apixaban & rivaroxaban), have been developed. New orally administered anticoagulant drugs have emerged as potential alternatives to VKAs for the prevention of ischaemic stroke or systemic embolism in patients with chronic atrial fibrillation. Novel oral anticoagulants (NOACs), due to their a lot of predictable therapeutic result and more favorable haemorrhagic risk profile, represent a particularly attractive therapeutic option in AF patients.
 Keywords: Novel oral anticoagulants (NOACs), Vitamin K antagonist (VKAs), Atrial fibrillation, Apixaban, Dabigatran, Rivaroxaban.
Highlights
Atrial fibrillation is characterized as an extremely rapid and disorganized atrial activation
We found no conclusive outcome with respect to major bleeding and gastrointestinal bleeding but found a substantial decrease in the risk for intracranial bleeding
novel oral anticoagulant drugs (NOACs) were comparable to Vitamin K antagonists (VKAs) in the prevention of ischemic stroke and systemic embolism, without being associated with an overall increased risk of serious adverse events
Summary
Atrial fibrillation is characterized as an extremely rapid and disorganized atrial activation. VKAs have significant limitations, their unpredictable anticoagulant response and numerous food and drug interactions, mandating regular laboratory monitoring These limitations make treatment with VKAs problematic for many patients; as a result, only about half of all potentially eligible AF patients are treated with VKAs. Over the last several years, novel oral anticoagulant drugs (NOACs), including direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (apixaban & rivaroxaban ), have been developed. Over the last several years, novel oral anticoagulant drugs (NOACs), including direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (apixaban & rivaroxaban ), have been developed These drugs have the potential to address some of the limitations of VKAs. These drugs have the potential to address some of the limitations of VKAs These agents have fewer food and drug interactions and a lot of predictable anticoagulant effect, allowing fixed dosing without the need for laboratory monitoring. Results support the use of the new oral anticoagulants as alternatives to VKAs for long-term anticoagulation therapy in patients with AF. [7]
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