The Importance of Non-vitamin K Antagonists (NOAC) in Their Current Use

Abstract

Non-vitamin K oral anticoagulants are new drugs that are used in the treatment of atrial fibrillation and venous thromboembolism. There are 4 NOACs in use today; dabigatran is a direct thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are Factor Xa inhibitors. NOACs can be used safely in AF patients, except for patients with moderate to severe rheumatic mitral stenosis, and metallic prosthetic valves. In studies where NOACs were evaluated in terms of effectiveness and safety, similar or better results were obtained with VKAs. With the new two antidotes (idaricuzimab and andexanet alfa) approved for use in NOAC-related bleeding, the potential for use of NOACs in patients with high bleeding risk is expected to increase.