Hematology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Howard-802, New York, NY 10065, USA.
Arterioscler Thromb Vasc Biol. 2012 Mar;32(3):569-74. doi: 10.1161/ATVBAHA.111.242834.
After more than 50 years of thrombosis treatment and prophylaxis being based on heparin and vitamin K antagonists, a new generation of oral, direct anticoagulants is now available. The past 5 years have brought a strikingly large number of trials that evaluated these new oral anticoagulants in a range of clinical trials, particularly nonvalvular atrial fibrillation, thrombosis prophylaxis after major joint replacement surgery, treatment of venous thromboembolic events, and, most recently, acute coronary syndrome. These studies have been notably similar in design between the drugs for specific indication. This review focuses on the 3 drugs that either have recently been approved by the US Food and Drug Administration (dabigatran and rivaroxaban) or have the most mature phase III clinical data (apixaban).
在基于肝素和维生素 K 拮抗剂进行血栓治疗和预防 50 多年后，新一代口服、直接抗凝剂现已问世。过去 5 年中，大量临床试验评估了这些新型口服抗凝剂，尤其是在非瓣膜性心房颤动、大关节置换术后血栓预防、静脉血栓栓塞事件治疗以及最近的急性冠脉综合征方面。这些研究在特定适应证的药物之间在设计上非常相似。这篇综述重点介绍了最近获得美国食品和药物管理局（FDA）批准的 3 种药物（达比加群和利伐沙班）或具有最成熟的 III 期临床数据的药物（阿哌沙班）。
