Direct Oral Anticoagulant Use: A Practical Guide to Common Clinical Challenges.

Journal of the American Heart Association
Ashley ChenBruce A Warden

Abstract

Direct oral anticoagulants (DOACs) have quickly become attractive alternatives to the long-standing standard of care in anticoagulation, vitamin K antagonist. DOACs are indicated for prevention and treatment of several cardiovascular conditions. Since the first approval in 2010, DOACs have emerged as leading therapeutic alternatives that provide both clinicians and patients with more effective, safe, and convenient treatment options in thromboembolic settings. With the expanding role of DOACs, clinicians are faced with increasingly complex decisions relating to appropriate agent, duration of treatment, and use in special populations. This review will provide an overview of DOACs and act as a practical reference for clinicians to optimize DOAC use among common challenging scenarios. Topics addressed include (1) appropriate indications; (2) use in patients with specific comorbidities; (3) monitoring parameters; (4) transitioning between anticoagulant regimens; (5) major drug interactions; and (6) cost considerations.

References

Jul 11, 2003·The New England Journal of Medicine·Agnes Y Y LeeUNKNOWN Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Veno
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Feb 24, 2011·Circulation·Valentin Fuster, Joseph M Sweeny
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators
Nov 15, 2011·The New England Journal of Medicine·Jessica L MegaUNKNOWN ATLAS ACS 2–TIMI 51 Investigators
Jul 21, 2012·Drug Metabolism and Pharmacokinetics·Takahiko TanigawaWolfgang Mueck
Dec 12, 2012·The New England Journal of Medicine·Giancarlo AgnelliUNKNOWN AMPLIFY-EXT Investigators
Apr 4, 2013·Stroke; a Journal of Cerebral Circulation·Amanda R HarringtonDaniel C Malone
Jun 21, 2013·The New England Journal of Medicine·Lorenz BreuerMartin Köhrmann
Jul 3, 2013·The New England Journal of Medicine·Giancarlo AgnelliUNKNOWN AMPLIFY Investigators
Sep 3, 2013·The New England Journal of Medicine·John W EikelboomUNKNOWN RE-ALIGN Investigators
Nov 21, 2013·The New England Journal of Medicine·Robert P GiuglianoUNKNOWN ENGAGE AF-TIMI 48 Investigators
Sep 13, 2014·Journal of the American College of Cardiology·Adam CukerDavid A Garcia
Sep 23, 2014·Journal of the Neurological Sciences·Apostolos SafourisGeorgios Tsivgoulis
Aug 19, 2015·JAMA : the Journal of the American Medical Association·Agnes Y Y LeeUNKNOWN CATCH Investigators
Sep 20, 2015·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Ajay YadlapatiRod Passman
Mar 26, 2016·Journal of the American College of Cardiology·Muthiah VaduganathanUNKNOWN COGENT Investigators
Apr 23, 2016·Stroke; a Journal of Cerebral Circulation·Anuj ShahBradley C Martin
May 28, 2016·The New England Journal of Medicine·Alexander T CohenUNKNOWN APEX Investigators
Jun 15, 2016·Journal of Thrombosis and Haemostasis : JTH·K MartinS Moll
Jul 1, 2016·Circulation·Erin A BohulaEugene Braunwald
Dec 14, 2016·The New England Journal of Medicine·C Michael GibsonKeith A Fox
Feb 9, 2017·Circulation·Amish N RavalUNKNOWN American Heart Association Clinical Pharmacology Subcommittee of the Acute Cardiac Care and General Cardiology Committee of
Feb 18, 2017·Circulation·Anthony P CarnicelliUNKNOWN ENGAGE AF-TIMI 48 Investigators
Mar 18, 2017·Journal of the American College of Cardiology·Giulia RendaRaffaele De Caterina
Jun 10, 2017·Journal of the American College of Cardiology·Xiaoxi YaoPeter A Noseworthy
Aug 29, 2017·The New England Journal of Medicine·John W EikelboomUNKNOWN COMPASS Investigators
Aug 29, 2017·The New England Journal of Medicine·Christopher P CannonUNKNOWN RE-DUAL PCI Steering Committee and Investigators
Dec 1, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Martín Ruiz OrtizUNKNOWN FANTASIIA study investigators

❮ Previous
Next ❯

Citations

Jan 5, 2021·Journal of Clinical Pharmacy and Therapeutics·Daniel WadsworthJennifer Kim
Jan 26, 2021·Expert Opinion on Pharmacotherapy·Agnieszka KotalczykGregory Y H Lip
Nov 19, 2020·Risk Management and Healthcare Policy·Tamrat Assefa TadesseAlfoalem Araba Abiye
Nov 21, 2020·Biomedicines·Amine Ghembaza, David Saadoun
Mar 3, 2021·Journal of Thrombosis and Haemostasis : JTH·Weikai Li
Apr 4, 2021·Biomedicines·Hannah L McRaeMajed A Refaai
May 9, 2021·European Journal of Clinical Pharmacology·Maryam DaeiZinat Heidari
Mar 4, 2021·Critical Care Medicine·Cherylee W J ChangShreyansh Shah
May 4, 2021·The American Journal of Medicine·Jean TerrierCaroline F Samer
May 21, 2021·Research and Practice in Thrombosis and Haemostasis·Smrithi SukumarJanice B Schwartz
Jun 19, 2021·Cardiovascular Drugs and Therapy·Robert BenamouzigLaurent Fauchier
Jun 15, 2021·Frontiers in Pharmacology·Roberta RobertiRita Citraro
Jul 22, 2021·Acta Neurologica Scandinavica·Gaurav NepalGentle Sunder Shrestha
Oct 6, 2021·JAMA : the Journal of the American Medical Association·Daniel S BudnitzDaniel A Pollock
Jun 11, 2021·Annual Review of Nutrition·Michael S DanielsDiane L McKay
Jun 17, 2021·Clinical and Molecular Hepatology·Ho Soo ChunTae Hun Kim
Dec 17, 2021·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andreas D MeidWalter E Haefeli

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy
amputations
coronary artery bypass

Clinical Trials Mentioned

NCT02228798

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.