Abstract

BUITRAGO, Andrés F; GOMEZ, Mabel; SOTO, Mariana  and  DIAZ, Jesús H. New oral ant icoagulants in nonvalvular atrial fibrillation. Rev. Colomb. Cardiol. [online]. 2012, vol.19, n.4, pp.184-191. ISSN 0120-5633.

Atrial fibrillation is the most common sustained cardiac arrhythmia and its prevalence doubles every decade for people older than fifty years. Meanwhile, the clinical conditions most associated with it are hypertension, heart failure, valvular heart disease and diabetes mellitus. Complications include heart failure, but perhaps one of the worst ones are the stroke events, which occur in approximately 4.5% of not anticoagulated patients. Antithrombotic therapy with vitamin K antagonists was for over fifty years the only alternative available, despite its many limitations. These limitations led to the development of new anticoagulant drugs that reduce many of the problems of vitamin K antagonists. They fall into two classes: direct oral thrombin inhibitors and oral activated factor X inhibitors. Dabigatran, rivaroxaban and apixaban, already rely on randomized controlled trials that support its use in antithrombotic therapy for atrial fibrillation and were recently included in the evidence-based guidelines as an alternative (ACC) and even with a higher grade of recommendation (CCS, CHEST) to that of the the vitamin K antagonists.

Keywords : atrial fibrillation; anticoagulants; evidence-based medicine.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )