Hatékony, biztonságos stroke-prevenció pitvarfibrilláció esetén új típusú orális antikoagulánsokkal. Fókuszban a dabigatran

Translated title of the contribution: Effective, safe stroke prevention with novel oral anticoagulants in patients with atrial fibrillation. Focus on dabigatran

László Szapáry, Gergely Fehér, Edit Bosnyák, Gabriella Deli, Péter Csécsei

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Non-valvular AF is the most common cardiac arrhytmia. Its incidence increases with age. AF is an independent risk factor for ischaemic stroke, representing a five times higher risk for it, associated with a high mortality rate. Beside AF, there are several other risk factors which influence the risk of stroke. Stroke risk calculator can be used to assess the risk of patient having a stroke. The most endangered group of patients with AF are those who have already suffered from cerebrovascular event. The only effective medication for prevention of stroke due to AF had been the application of vitamin K antagonists (VKA) which considerably decrease the rate of ischaemic event in a patient with AF providing that the INR is in the therapeutic range. VKA have several limitations of use in clinical practice and the fear of bleeding complications results an underusing of these drugs. Only 50% of all patients treated with VKA reaches the therapeutic range of INR. The breakthrough of prevention of stroke in recent years is undisputedly the coming out of novel oral anticoagulants (NOACs, thrombin and Xa-factor inhibitors). Recent studies suggest that these novel drugs prove the same efficacy as VKA drugs, furthermore dabigatran in a dose of 2x150 mg or apixaban in 2x5mg was statistically superior to warfarin in the prevention of stroke. NOACs have shown a large reduction in intracranial hemorrhage compared with warfarin. They are given as a fixed dose and do not require persistent monitoring making them much more convenient. NOACs at guidelines of European Society of Cardiology act as a preferable drugs in case of ischaemic stroke with AF. Probably the extended use of NOACs in clinical practice will be the mainstream of stroke prevention in the future.

Original languageHungarian
Pages (from-to)165-174
Number of pages10
JournalIdeggyogyaszati szemle
Volume66
Issue number5-6
Publication statusPublished - May 30 2013

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ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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