Document Type : Review Article
Authors
1 Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences.
2 PhD Candidate in Clinical Pharmacy, Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Atrial Fibrillation (AF) is one of the most common arrhythmias that expose patients to thromboembolic events and hemodynamic instabilities. These events increase the risk of developing heart failure, myocardial infarction, sudden cardiac death, and dementia that eventually increase the rate of mortality in patients. The use of anticoagulants can prevent the mentioned severe adverse events. Two commonly used oral anticoagulant groups in AF patients are vitamin K antagonists (warfarin) and non-vitamin K oral antagonists (NOACs) that consist of direct factor Xa inhibitors and direct factor IIa inhibitors. Previous research proved the efficacy of both groups in reducing ischemic events in AF patients. In this review article, we were to evaluate and compare the safety and efficacy of these agents in reducing ischemic and thromboembolic events in AF patients with complicated risk factors such as chronic kidney disease, prosthetic heart valve, history of previous intracranial hemorrhage, etc. Finally, the reversal agents of these anticoagulants have been reviewed in case of severe bleeding, intoxication, and the urgent need for emergency surgery.
Keywords
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