Summary:
One of the most common and useful forms of medical
intervention is anticoagulant therapy and it is the mainstay
of treatment and prevention of thrombosis in different
clinical settings, like atrial fibrillation (AF), acute coronary
syndrome (ACS), acute venous thromboembolism (VTE),
and in patients undergoing invasive cardiac procedures.
More than 6 million patients in the United States receive
long-term anticoagulation therapy for the prevention of
thromboembolism due to AF, placement of a mechanical
heart-valve prosthesis, or VTE.1 For more than 60 years,
until 2009, warfarin and other vitamin K antagonists were
the only class of oral anticoagulants (OAC) available.
Although these drugs are highly effective in prevention of
TE, their use is limited by a narrow therapeutic index that
necessitates frequent monitoring and dose adjustments.
This results in substantial risk and inconvenience, leading
to inadequate anticoagulant prophylaxis. Recently some
new OAC have been marketed which are effective, easier
to use and has less side effects. Dabigatran is a new oral
thrombin inhibitor and Rivaroxaban, Apixaban and
Edoxaban are oral factor Xa inhibitors. This review outlines
why these new OACs were essential and describes in detail
about these new drugs.
(J Bangladesh Coll Phys Surg 2019; 37: 135-150)
DOI: https://doi.org/10.3329/jbcps.v37i3.41736