New Oral Anticoagulants in Atrial Fibrillation

Cid-Conde, Lucía; Castro, José López

doi:10.5772/53614

Cited by 2 publications

(1 citation statement)

References 45 publications

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“…10,11 The chronic use of oral anticoagulants can influence QoL, and poor adherence increases morbimortality and overall health care costs. 12 Previous systematic reviews have evaluated these outcomes in anticoagulated patients; 1,13,14 however, no review has systematically evaluated these outcomes comparing DOACs and VKAs, exclusively in patients with nonvalvular AF. This systematic review aims to evaluate the adherence and QoL in patients with non-valvular AF using DOACs compared to patients using VKAs.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Adherence and Quality of Life in Non-Valvular Atrial Fibrillation With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review

Zortéa¹,

Curvello²,

Pilger³

et al. 2023

International Journal of Cardiovascular Sciences

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Background: Direct anticoagulants (DOACs) and vitamin K antagonists (VKAs) differ in pharmacokinetic characteristics, intensity of required laboratory monitoring, and costs. These differences could affect patients' adherence to treatment and quality of life (QoL).Objective: To assess whether patients with non-valvular atrial fibrillation (AF) using DOACs have better treatment adherence and QoL when compared to patients using VKAs. Methods:We conducted a systematic review in Medline, Embase, LILACS, SciELO, CINAHL, and Cochrane Central, until June 9, 2021. We included studies that estimated and compared treatment adherence and QoL between DOACs and VKAs in adults with non-valvular AF. The methodological quality of the studies was assessed using the Joanna Briggs Institute (JBI) tools. The protocol was registered in the PROSPERO (CRD 42020165238).Results: Sixteen studies, including 122,458 patients with non-valvular AF, evaluated adherence, and eleven studies, including 5,687 patients, assessed QoL. A variety of methods was used to measure adherence. Eleven studies showed no difference in adherence between DOACs and VKAs, while three studies favored VKAs over DOACs and two studies favored DOACs over VKAs. QoL was measured by specific (n = 3) or generic questionnaires (n = 8); results favored DOACs over VKAs in four studies, while in the other seven studies the results showed no difference between the groups. Meta-analyses were not performed due to high methodological heterogeneity among studies.Conclusions: Available evidence regarding treatment adherence and QoL with DOACs and VKAs is characterized by methodological heterogeneity and conflicting findings.

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Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Adherence and Quality of Life in Non-Valvular Atrial Fibrillation With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review

Zortéa¹,

Curvello²,

Pilger³

et al. 2023

International Journal of Cardiovascular Sciences

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Dabigatran Acylglucuronide, the Major Metabolite of Dabigatran, Shows a Weaker Anticoagulant Effect than Dabigatran

et al. 2022

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Dabigatran (DAB) is an orally administered thrombin inhibitor. Both DAB and its main metabolite dabigatran acylglucuronide (DABG) have established anticoagulant effects. Here, we aimed to compare the relative anticoagulant effects of DABG and DAB in humans. Anticoagulant effects of DAB and DABG were measured in vitro using a thrombin generation assay. Additionally, their effects on other coagulation assays including PT, aPTT, TT, and fibrinogen were compared. Both DAB and DABG showed inhibitory effects on thrombin generation in a dose-dependent manner, but DABG exhibited a weaker inhibitory effect than that of DAB. The IC50 values of DAB and DABG on thrombin generation AUC were 134.1 ng/mL and 281.9 ng/mL, respectively. DABG also exhibited weaker anticoagulant effects than DAB on PT, aPTT, and TT. The results of the present study indicate that the anticoagulant effect of DABG, a main active DAB metabolite, is weaker than that of DAB.

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New Oral Anticoagulants in Atrial Fibrillation

Abstract: Stroke or transient ischemic attack (TIA) 2 Maximum score 6 Table 2. Stroke risk stratification with the CHADS 2 score Atrial Fibrillation-Mechanisms and Treatment 208

Cited by 2 publications

References 45 publications

Adherence and Quality of Life in Non-Valvular Atrial Fibrillation With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review

Adherence and Quality of Life in Non-Valvular Atrial Fibrillation With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review

Dabigatran Acylglucuronide, the Major Metabolite of Dabigatran, Shows a Weaker Anticoagulant Effect than Dabigatran

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