Review: New Oral Anticoagulants for Afib, VTE, and ACS
Review: New Oral Anticoagulants for Afib, VTE, and ACS
This Resident Journal Review includes recent studies concerning the use of new oral anticoagulants for stroke prophylaxis in atrial fibrillation, VTE, and ACS. Although the studies have not demonstrated efficacy in their use for ACS, they are encouraging that dabigatran, rivaroxaban, and apixaban can provide comparable if not superior efficacy and reduced risk of bleeding when compared to warfarin in the treatment of VTE and stroke prevention. However, effective reversal agents have yet to be identified and studied adequately for use in the setting of a major bleed. Regardless, we will continue to see patients taking new oral anticoagulants and must be familiar with the pharmacology of each and how to approach reversing the anticoagulation in the safest and most rapid manner possible.
Summary
This Resident Journal Review includes recent studies concerning the use of new oral anticoagulants for stroke prophylaxis in atrial fibrillation, VTE, and ACS. Although the studies have not demonstrated efficacy in their use for ACS, they are encouraging that dabigatran, rivaroxaban, and apixaban can provide comparable if not superior efficacy and reduced risk of bleeding when compared to warfarin in the treatment of VTE and stroke prevention. However, effective reversal agents have yet to be identified and studied adequately for use in the setting of a major bleed. Regardless, we will continue to see patients taking new oral anticoagulants and must be familiar with the pharmacology of each and how to approach reversing the anticoagulation in the safest and most rapid manner possible.
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