Usage and safety of direct oral anticoagulants at patients with atrial fibrillation and planned diagnostic procedures, interventions, and surgery

Abstract

Atrial fibrillation (AF) affects about 2% of the population, with the increasing prevalence with age. It is associated with poorer quality of life, effort intolerance, frequent hospitalizations, heart failure, and increased risk of systemic embolization, stroke, and mortality. Warfarin has been the only choice of chronic anticoagulant therapy for over 50 years. Its disadvantages are reflected by interaction with various foods, drugs, and alcohol, while its action is highly dependent on liver function, age, and genetic background. Administration of direct oral anticoagulants (DOACs) to patients with AF and acceptable bleeding risk reduces the risk of systemic thromboembolic complications and stroke; these drugs are superior or at least as effective as warfarin. Their use is safer than warfarin in terms of reduced risk of major bleeding. This is a group of drugs with wide clinical use, except in patients with severely impaired renal and hepatic function. Proper use is a guarantee of the safety of DOACs, which in the future will be even more pronounced with the advent of new antidotes, such as Praxbind.

Keywords

• atrial fibrillation
• direct oral anticoagulant
• risk reduction
• safety
• stroke
• thromboembolism
• warfarin