Perspectives: Direct and specific inhibition of factor Xa: An emerging therapeutic strategy for atherothrombotic disease

Abstract

Atherosclerotic disease is the leading cause of morbidity and mortality worldwide. Despite advances in the medical treatment to acute coronary syndrome (ACS), the mortality and recurrence of ACS are still exceedingly high, thus further treatment optimization is needed. The need to reduce future cardiovascular events has led to the development of novel therapies to prevent coronary thrombosis, targeting the coagulation pathway, specifically active factor X (Xa). Several factor Xa inhibitors (rivaroxaban, apixaban, darexaban, otamixaban) have been recently developed and studied in the context of ACS. This article critically reviews the comparative mechanisms of action, the risks and benefits, together with the clinical evidence base for the use of these novel Xa inhibitors in the management of ACS patients. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013.