New anticoagulants for atrial fibrillation.

Abstract

Atrial fibrillation is already the most common clinically significant cardiac arrhythmia and a common cause of stroke. Vitamin K antagonists are very effective for the prevention of cardioembolic stroke but have numerous limitations that limit their uptake in eligible patients with AF and reduce their effectiveness in treated patients. Multiple new anticoagulants are under development as potential replacements for vitamin K antagonists. Most are small synthetic molecules that target factor IIa (e.g., dabigatran etexilate, AZD-0837) or factor Xa (e.g., rivaroxaban, apixaban, betrixaban, DU176b, idrabiotaparinux). These drugs have predictable pharmacokinetics that allow fixed dosing without laboratory monitoring, and are being compared with vitamin K antagonists or aspirin in phase III clinical trials [corrected]. A new vitamin K antagonist (ATI-5923) with improved pharmacological properties compared with warfarin is also being evaluated in a phase III trial. None of the new agents have as yet been approved for clinical use.

• Authors: Magdalena Sobieraj-Teague, Martin O'Donnell, John Eikelboom
• Journal: Seminars in thrombosis and hemostasis (Semin Thromb Hemost) Vol. 35 Issue 5 Pg. 515-24 (Jul 2009) ISSN: 1098-9064 [Electronic] United States
• PMID: 19739042 (Publication Type: Journal Article, Review)
• Copyright: Copyright Thieme Medical Publishers.

Chemical References

• Anticoagulants
• Benzamides
• Benzimidazoles
• Factor Xa Inhibitors
• Morpholines
• Oligosaccharides
• Pyrazoles
• Pyridines
• Pyridones
• Thiazoles
• Thiophenes
• Vitamin K
• apixaban
• idraparinux
• Biotin
• betrixaban
• Rivaroxaban
• idrabiotaparinux
• Dabigatran
• edoxaban

Topics

• Anticoagulants (therapeutic use)
• Atrial Fibrillation (drug therapy)
• Benzamides (therapeutic use)
• Benzimidazoles (therapeutic use)
• Biotin (analogs & derivatives, therapeutic use)
• Clinical Trials, Phase III as Topic
• Dabigatran
• Factor Xa Inhibitors
• Humans
• Morpholines (therapeutic use)
• Oligosaccharides (therapeutic use)
• Pyrazoles (therapeutic use)
• Pyridines (therapeutic use)
• Pyridones (therapeutic use)
• Rivaroxaban
• Thiazoles (therapeutic use)
• Thiophenes (therapeutic use)
• Vitamin K (antagonists & inhibitors)