Berthold H K
Klinik für Innere Medizin und Geriatrie, Evangelisches Krankenhaus Bielefeld (EvKB), Schildescher Str. 99, 33611, Bielefeld, Deutschland,
Internist (Berl). 2014 Jan;55(1):93-101. doi: 10.1007/s00108-013-3409-2.
The new oral anticoagulants (NOAC) are alternative drugs to classical vitamin K antagonists (VKA) for stroke prevention in patients with nonvalvular atrial fibrillation. They have been shown in randomized trials to be superior to warfarin in reducing clinical endpoints, although at rather small effect sizes. However, in study centers with good anticoagulation management their superiority was barely significant. The effectiveness of anticoagulation therapy is crucially dependent on individual drug adherence. NOAC potentially decrease adherence due to several reasons, among them the twice-daily dosing requirement in some of them and the nonnecessity for anticoagulation monitoring. Anticoagulation monitoring is assumed to increase adherence per se. VKA are potentially better suitable to compensate for low adherence due to their long half-lives.
新型口服抗凝药（NOAC）是传统维生素K拮抗剂（VKA）用于非瓣膜性心房颤动患者预防卒中的替代药物。随机试验表明，尽管其效应量较小，但在降低临床终点方面，它们优于华法林。然而，在抗凝管理良好的研究中心，其优势并不显著。抗凝治疗的有效性关键取决于个体的药物依从性。由于多种原因，NOAC可能会降低依从性，其中包括部分药物需要每日给药两次以及无需进行抗凝监测。抗凝监测本身被认为可提高依从性。由于VKA半衰期长，它们可能更适合弥补依从性差的情况。
