Journal of clinical medicine · 2023
Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Lucà Fabiana, Oliva Fabrizio, Abrignani Maurizio Giuseppe, Di Fusco Stefania Angela, Parrini Iris, Canale Maria Laura, Giubilato Simona, Cornara Stefano, Nesti Martina, Rao Carmelo Massimiliano, Pozzi Andrea, Binaghi Giulio, Maloberti Alessandro, Ceravolo Roberto, Bisceglia Irma, Rossini Roberta, Temporelli Pier Luigi, Amico Antonio Francesco, Calvanese Raimondo, Gelsomino Sandro, Riccio Carmine, Grimaldi Massimo, Colivicchi Furio, Gulizia Michele Massimo
Аннотация
It is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH). In addition, many factors, such as fewer pharmacokinetic interactions and less need for monitoring, contribute to the favor of this therapeutic strategy. Although DOACs represent a more suitable option, several issues should be considered in clinical practice, including drug-drug interactions (DDIs), switching to other antithrombotic therapies, preprocedural and postprocedural periods, and the use in patients with chronic renal and liver failure and in those with cancer. Furthermore, adherence to DOACs appears to remain suboptimal. This narrative review aims to provide a practical guide for DOAC prescription and address challenging scenarios.