Abstract |
The advent of direct oral anticoagulants (DOACs) has revolutionized anticoagulation management in both stroke prevention and venous thromboembolism (VTE) treatment/prevention. Clinical trials and secondary real-world data have shown that DOACs have similar efficacy and, in some cases, improved bleeding safety profiles compared with vitamin K antagonists. Together with benefits of patient convenience, this has shifted the risk-benefit ratio toward long-term anticoagulation. However, current VTE risk assessment models are based on vitamin K antagonists and do not take into account the new paradigm of DOACs. Therefore, challenges to the thrombosis community remain to determine patients who would benefit from long-term anticoagulation in the DOAC era. Here, the authors review the current literature on risks and benefits of DOACs and their potential role in long-term VTE thromboprophylaxis as well as in current risk assessment models. The increasing use of DOACs, led by their convenience of use and generally lower bleeding rates, calls for a reevaluation of the current models as the benefits of long-term anticoagulation may begin to outweigh risks and inconvenience associated with their predecessors.
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Authors | Hui Yin Lim, Harshal Nandurkar, Prahlad Ho |
Journal | Seminars in thrombosis and hemostasis
(Semin Thromb Hemost)
Vol. 44
Issue 3
Pg. 261-266
(Apr 2018)
ISSN: 1098-9064 [Electronic] United States |
PMID | 29558778
(Publication Type: Journal Article, Review)
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Copyright | Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. |
Chemical References |
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Topics |
- Administration, Oral
- Anticoagulants
(pharmacology, therapeutic use)
- Humans
- Venous Thromboembolism
(drug therapy, pathology)
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