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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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After recent randomized control trials (RCTs), non-vitamin K oral anticoagulants (NAOAs) are now widely being used in patients with atrial fibrillation (AF) worldwide. However, current guidelines for the use of NOACs in patients with AF are derived mostly using a Caucasian population and nonstroke patients. Relatively few Asian patients with AF and stroke are included in the recent RCTs. As a result, the optimal use of NOACs in this particular group of patients is remains to be settled. The optimal dose of NOACs and response to current dose of NOACs of Asian patients with AF and stroke may differ from those of westerners and patients without stroke. We reviewed available research on NOACs by searching PubMed and ClinicalTrials.gov published in English up to December 2015. In this review, the characteristics of Asian AF patients with prior stroke/transient ischemic attack, which might influence the efficacy and safety profiles of NOACs, are discussed. In addition, we summarize the risk factors for bleeding complications on NOACs, which are related or unrelated with the blood level of NOACs. Lastly, we provide recent data of reduced dose of NOACs from RCTs or large cohorts. The results reviewed herein call for clinical trials to test whether a reduced dose of NOACs is beneficial in Asian patients with AF and stroke. In the meantime, further researches are needed to establish the safety and efficacy of dose-adjusted NOACs considering both blood levels of NOACs and fragility of patients in Asian patients with AF and stroke.
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참고문헌 (70)
참고문헌 신청
Connolly SJ / 2009 / Dabigatran versus warfarin in patients with atrial fibrillation / N Engl J Med 361:1139~1151
Patel MR / 2011 / Rivaroxaban versus warfarin in nonvalvular atrial fibrillation / N Engl J Med 365:883~891
Granger CB / 2011 / Apixaban versus warfarin in patients with atrial fibrillation / N Engl J Med 365:981~992
Giugliano RP / 2013 / Edoxaban versus warfarin in patients with atrial fibrillation / N Engl J Med 369:2093~2104
Yoon CH / 2014 / Eligibility and preference of new oral anticoagulants in patients with atrial fibrillation : comparison between patients with versus without stroke / Stroke 45:2983~2988
Patel MR / 2011 / Rivaroxaban versus warfarin in nonvalvular atrial fibrillation / N Engl J Med 365:883~891
Granger CB / 2011 / Apixaban versus warfarin in patients with atrial fibrillation / N Engl J Med 365:981~992
Giugliano RP / 2013 / Edoxaban versus warfarin in patients with atrial fibrillation / N Engl J Med 369:2093~2104
Yoon CH / 2014 / Eligibility and preference of new oral anticoagulants in patients with atrial fibrillation : comparison between patients with versus without stroke / Stroke 45:2983~2988
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