New Oral Anticoagulants in AF and Acute Coronary Syndromes
New Oral Anticoagulants in AF and Acute Coronary Syndromes
Drugs that interfere with blood coagulation (anticoagulants) are a mainstay of cardiovascular therapy. Until recently, vitamin K antagonists (VKAs) were the only available orally active anticoagulants. Although effective, VKAs have numerous limitations, which complicate their use. These limitations have prompted the introduction of new oral anticoagulants that target thrombin and factor (F) Xa, key enzymes in the coagulation pathway. The new oral anticoagulants, which can be given in fixed doses without routine coagulation monitoring, overcome many of the problems associated with VKAs.
This document, produced by a committee appointed by the European Society of Cardiology Working Group on Thrombosis and assembling a group of coagulation experts and clinical cardiologists, aims to: 1) review the mechanism of action, pharmacologic properties, and side effects of the new anticoagulants; and 2) describe and comment on the results of recently completed clinical trials in 2 specific cardiac conditions, atrial fibrillation and acute coronary syndromes.
This document is intended to follow and complement the Task Force Document on the use of Antiplatelet Agents in Atherothrombotic Diseases and is an update of a previous document.
Preamble: Purposes and Scope of the Task Force
Drugs that interfere with blood coagulation (anticoagulants) are a mainstay of cardiovascular therapy. Until recently, vitamin K antagonists (VKAs) were the only available orally active anticoagulants. Although effective, VKAs have numerous limitations, which complicate their use. These limitations have prompted the introduction of new oral anticoagulants that target thrombin and factor (F) Xa, key enzymes in the coagulation pathway. The new oral anticoagulants, which can be given in fixed doses without routine coagulation monitoring, overcome many of the problems associated with VKAs.
This document, produced by a committee appointed by the European Society of Cardiology Working Group on Thrombosis and assembling a group of coagulation experts and clinical cardiologists, aims to: 1) review the mechanism of action, pharmacologic properties, and side effects of the new anticoagulants; and 2) describe and comment on the results of recently completed clinical trials in 2 specific cardiac conditions, atrial fibrillation and acute coronary syndromes.
This document is intended to follow and complement the Task Force Document on the use of Antiplatelet Agents in Atherothrombotic Diseases and is an update of a previous document.