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Noncanonical Effects of Oral Thrombin and Factor Xa Inhibitors in Platelet Activation and Arterial Thrombosis.

Abstract
Nonvitamin K oral anticoagulants (NOACs) or direct oral anticoagulants comprise inhibitors of factor Xa (rivaroxaban, apixaban, edoxaban) or factor IIa (dabigatran). Both classes efficiently interfere with the final or penultimate step of the coagulation cascade and showed superior net clinical benefit compared with vitamin K antagonists for prevention of thromboembolic events in patients with AF and for prevention and therapy of deep vein thrombosis and pulmonary embolism. None the less, accumulating data suggested, that there may be differences regarding the frequency of atherothrombotic cardiovascular events between NOACs. Thus, the optimal individualized NOAC for each patient remains a matter of debate. Against this background, some basic and translational analyses emphasized NOAC effects that impact on platelet activity and arterial thrombus formation beyond inhibition of plasmatic coagulation. In this review, we will provide an overview of the available clinical and translational evidence for so-called noncanonical NOAC effects on platelet activation and arterial thrombosis.
AuthorsAmin Polzin, Lisa Dannenberg, Manuela Thienel, Martin Orban, Georg Wolff, Thomas Hohlfeld, Tobias Zeus, Malte Kelm, Tobias Petzold
JournalThrombosis and haemostasis (Thromb Haemost) Vol. 121 Issue 2 Pg. 122-130 (Feb 2021) ISSN: 2567-689X [Electronic] Germany
PMID32942315 (Publication Type: Journal Article, Review)
CopyrightThieme. All rights reserved.
Chemical References
  • Factor Xa Inhibitors
  • Pyrazoles
  • Pyridines
  • Pyridones
  • Thiazoles
  • apixaban
  • Rivaroxaban
  • Dabigatran
  • edoxaban
Topics
  • Animals
  • Blood Coagulation (drug effects)
  • Dabigatran (therapeutic use)
  • Factor Xa Inhibitors (therapeutic use)
  • Humans
  • Platelet Activation (drug effects)
  • Pyrazoles (therapeutic use)
  • Pyridines (therapeutic use)
  • Pyridones (therapeutic use)
  • Rivaroxaban (therapeutic use)
  • Thiazoles (therapeutic use)
  • Thrombosis (blood, drug therapy)

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