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Upstream versus downstream thrombin inhibition.
- Source :
-
Expert review of cardiovascular therapy [Expert Rev Cardiovasc Ther] 2016 Nov; Vol. 14 (11), pp. 1273-1282. Date of Electronic Publication: 2016 Aug 30. - Publication Year :
- 2016
-
Abstract
- Introduction: For a long time, vitamin K antagonists (VKA) have been the preferred drugs for the anticoagulation management of both atrial fibrillation and venous thromboembolism. Hereby, the major purpose is to attenuate the onset of thrombosis without affecting hemostasis. Areas covered: Nowadays, non-vitamin K anticoagulants (NOAC), a new class of oral anticoagulants is available for the above-mentioned indications. NOAC are at least as effective and safer with regard to intracranial bleedings compared to VKA, but major bleedings still occur. For this reason, the search for safer anticoagulants is still ongoing. Expert commentary: There are several unmet needs in NOAC management, including selection of optimal drug and dose, uncertainty on specific conditions and lack of drug persistence. There remains to be an important need for safer anticoagulants; 'upstream' anticoagulants including inhibitors of factor XIa may provide additional benefit related to fewer bleeding complications.
- Subjects :
- Administration, Oral
Anticoagulants adverse effects
Anticoagulants therapeutic use
Antithrombins adverse effects
Antithrombins pharmacology
Antithrombins therapeutic use
Blood Coagulation drug effects
Blood Coagulation physiology
Fibrinolytic Agents adverse effects
Fibrinolytic Agents pharmacology
Fibrinolytic Agents therapeutic use
Humans
Thrombin physiology
Vitamin K adverse effects
Vitamin K antagonists & inhibitors
Warfarin adverse effects
Warfarin pharmacology
Anticoagulants pharmacology
Blood Coagulation Factors antagonists & inhibitors
Thrombin antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1744-8344
- Volume :
- 14
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Expert review of cardiovascular therapy
- Publication Type :
- Academic Journal
- Accession number :
- 27575701
- Full Text :
- https://doi.org/10.1080/14779072.2016.1224179