Use of Direct Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation According to Clinical Profile

Abstract

The majority of patients with atrial fibrillation should receive oral anticoagulation to reduce the risk of stroke. The limitations of vitamin K antagonists have led to an underuse of anticoagulants in clinical practice which has been associated with a higher risk of stroke, hospitalizations and healthcare costs. Direct oral anticoagulants (DOACs) overcome some of the limitations of vitamin K antagonists and may therefore increase the use of oral anticoagulants in clinical practice. Since no head-to-head trials have been performed, only indirect comparisons can be made among them. In this review, the results of the Phase III randomized controlled trials with DOACs were analyzed, trying to determine whether one or more DOACs could be especially recommended according to different clinical conditions.

KEYWORDS :

• anticoagulation
• apixaban
• atrial fibrillation
• dabigatran
• edoxaban
• rivaroxaban
• treatment

Financial & competing interests disclosure

V Barrios has received lecturing fees from Bayer, Boehringer Ingelheim, Daiichi Sankyo, Pfizer/Bristol Myers Squibb, consulting fees for participating in advisory boards from Bayer, Boehringer Ingelheim, Daiichi Sankyo and grants from Bristol Myers Squibb and Pfizer. J Masjuan has participated in advisory boards and lectures for Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo and Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was provided by Content Ed Net, Madrid, Spain, with funding from Boehringer Ingelheim.

Notes

Data taken from [32,35,37,40].