J Korean Med Assoc.  2013 Jan;56(1):57-61. 10.5124/jkma.2013.56.1.57.

New oral anticoagulants

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. seil@snu.ac.kr

Abstract

The most important and widely-prescribed drug for anticoagulation is a vitamin K antagonist such as warfarin although it has several limitations in clinical use. New oral anticoagulants (NOACs) have been developed to overcome these problems. The clinical efficacy and safety of dabigatran, rivaroxaban, and apixaban have been shown to be superior to warfarin through large-scale clinical trials. These NOACs can replace warfarin in significant proportions of patients with non-valvular atrial fibrillation to prevent stroke. Recent management guidelines for atrial fibrillation have already recommended NOACs for stroke prevention instead of warfarin. Future clinical studies should resolve the limitations of NOACs and try to extend their clinical indications.

Keyword

Arial fibrillation; Stroke; Anticoagulation

MeSH Terms

Anticoagulants
Atrial Fibrillation
Benzimidazoles
beta-Alanine
Dabigatran
Humans
Morpholines
Pyrazoles
Pyridones
Rivaroxaban
Stroke
Thiophenes
Vitamin K
Warfarin
Anticoagulants
Benzimidazoles
Morpholines
Pyrazoles
Pyridones
Thiophenes
Vitamin K
Warfarin
beta-Alanine

Figure

  • Figure 1 Time to peak concentration of each oral anticoagulant.

  • Figure 2 Coagulation cascades and targets of new oral anticoagulants. TF, tissue factor.

  • Figure 3 Half-life of each oral anticoagulant.


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