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Use of Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention across the Stroke Spectrum: Progress and Prospects.

Camm, AJ; Atar, D (2021) Use of Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention across the Stroke Spectrum: Progress and Prospects. Thromb Haemost, 121 (6). pp. 716-730. ISSN 2567-689X https://doi.org/10.1055/s-0040-1721665
SGUL Authors: Camm, Alan John

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Abstract

Multiple randomized controlled trials and many real-world evidence studies have consistently shown that non-vitamin K antagonist oral anticoagulants (NOACs) are preferable to vitamin K antagonists for thromboembolic stroke prevention in the majority of patients with atrial fibrillation (AF). However, their role in the management of patients with AF and comorbidities, as well as in other patient populations with a high risk of stroke, such as patients with prior embolic stroke of undetermined source (ESUS) and those with atherosclerosis, is less clear. There is now increasing evidence suggesting that NOACs have a beneficial effect in the prevention of stroke in patients with AF and comorbidities, such as renal impairment and diabetes. In addition, while studies investigating the efficacy and safety of NOACs for the prevention of secondary stroke in patients with a history of ESUS demonstrated neutral results, subanalyses suggested potential benefits in certain subgroups of patients with ESUS. One NOAC, rivaroxaban, has also recently been found to be effective in reducing the risk of stroke in patients with chronic cardiovascular disease including coronary artery disease and peripheral artery disease, further broadening the patient groups that may benefit from NOACs. In this article, we will review recent evidence for the use of NOACs across the stroke spectrum in detail, and discuss the progress and future prospects in the different stroke areas.

Item Type: Article
Additional Information: © 2021. Thieme. All rights reserved.
Keywords: 1103 Clinical Sciences, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Thromb Haemost
ISSN: 2567-689X
Language: eng
Dates:
DateEvent
June 2021Published
7 January 2021Published Online
31 October 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 33412613
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112855
Publisher's version: https://doi.org/10.1055/s-0040-1721665

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