Efficacy and safety of the novel oral anticoagulants for prevention of stroke and systemic embolism in atrial fibrillation

Abstract

Atrial fibrillation (AF) is one of the most prevalent rhythm disorders and might be associated with the high risk of thromboembolic complications, including stroke. For risk estimation, of the thrombotic complications, a variety of scores has been implemented, including CHA2DS2-VASc Score. According to the European Society of Cardiology Guidelines on AF management (2016), males showing more than 2 points, and females with more than 3 points by CHA2DS2-VASc, for embolism prevention, it is recommended to prescribe novel oral anticoagulants (NOAC). NOAC are effective and relatively safe comparing to vitamin K antagonists (VKA), are convenient being taken per os, do not have necessity of individual dosing, have rapid onset of the maximum effect (in several hours) and predictable effect in relation to dose. Among drugs from this group, dabigatran can be highlighted, which has in comparative studies shown not only high efficacy, but is the safest among all NOAC, as it does rarely lead to hemorrhagic complications and is the only NOAC for now, with the developed and available neutralizing agent — idarucizumab.