Department of Cardiology and Electrotherapy, Second Chair of Cardiology, Medical University of Gdansk, Poland.
Curr Pharm Des. 2013;19(21):3816-26. doi: 10.2174/1381612811319210007.
Patients with nonvalvular atrial fibrillation (AF) and risk factors for stroke need anticoagulation to avoid thromboembolic complications. Vitamin K antagonists (VKAs) are an established pharmacological group the use of which is recommended by guidelines. However, VKAs (like warfarin) have major disadvantages, such as a variable dose-effect relationship, drug and food interactions, the need for regular blood testing and dose titration, and, finally, a substantial risk of bleeding. New oral anticoagulants are intended to replace warfarin, being at least as safe and effective, and lacking some of the disadvantages of VKAs. Clinical data for dabigatran, rivaroxaban, apixaban and edoxaban, and other new drugs, are discussed in this article with special focus on their use in nonvalvular AF.
患有非瓣膜性心房颤动（AF）和中风风险因素的患者需要抗凝治疗以避免血栓栓塞并发症。维生素 K 拮抗剂（VKAs）是一种已确立的药理学药物，其使用被指南推荐。然而，VKAs（如华法林）存在许多主要缺点，例如剂量效应关系的可变性、药物和食物相互作用、需要定期进行血液检测和剂量调整，以及最后存在大量出血风险。新型口服抗凝剂旨在替代华法林，至少具有同样的安全性和有效性，并且缺乏一些 VKAs 的缺点。本文讨论了达比加群、利伐沙班、阿哌沙班和依度沙班以及其他新药的临床数据，特别关注它们在非瓣膜性 AF 中的应用。
