Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Medientyp: E-Artikel

Titel: Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Beteiligte: Lucà, Fabiana; Oliva, Fabrizio; Abrignani, Maurizio Giuseppe; Di Fusco, Stefania Angela; Parrini, Iris; Canale, Maria Laura; Giubilato, Simona; Cornara, Stefano; Nesti, Martina; Rao, Carmelo Massimiliano; Pozzi, Andrea; Binaghi, Giulio; Maloberti, Alessandro; Ceravolo, Roberto; Bisceglia, Irma; Rossini, Roberta; Temporelli, Pier Luigi; Amico, Antonio Francesco; Calvanese, Raimondo; Gelsomino, Sandro; Riccio, Carmine; Grimaldi, Massimo; Colivicchi, Furio; Gulizia, Michele Massimo

Erschienen: MDPI AG, 2023

Sprache: Englisch

DOI: 10.3390/jcm12185955

ISSN: 2077-0383

Schlagwörter: General Medicine

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Beschreibung: It is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH). In addition, many factors, such as fewer pharmacokinetic interactions and less need for monitoring, contribute to the favor of this therapeutic strategy. Although DOACs represent a more suitable option, several issues should be considered in clinical practice, including drug–drug interactions (DDIs), switching to other antithrombotic therapies, preprocedural and postprocedural periods, and the use in patients with chronic renal and liver failure and in those with cancer. Furthermore, adherence to DOACs appears to remain suboptimal. This narrative review aims to provide a practical guide for DOAC prescription and address challenging scenarios.

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