Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and is associated with a higher risk of thromboembolic events. CHA2DS2VASc score enables identification of those patients with AF who will most benefit from anticoagulation therapy and low-risk patients with AF who do not need any antithrombotic therapy. Antithrombotic drugs especially oral anticoagulants (OACs) are the mainstay of therapy to prevent stroke in patients with AF. Although vitamin K antagonists (VKAs) were the only available drugs for decades, numerous non-vitamin K antagonist oral anticoagulants (NOACs) have been developed and marketed for stroke prevention in recent years. The risk of stroke was reported to decline up to 68 % with OAC therapy, associated with good anticoagulation control with VKAs, assessed by time in therapeutic range (TTR). In low TTR values, VKAs were found to be associated with severe complications, and a minimum TTR of 58 % should be achieved to expect a net benefit from being on OAC therapy. Narrow therapeutic index, drug-drug interactions, and the need for close monitoring are the main disadvantages of VKAs, and management of patients have dramatically improved after the introduction of NOACs. NOACs have a more predictable anticoagulant affect which allows a fixed-dose regimen. The efficacy and safety of NOACs have been shown not only in large randomized controlled clinical trials but also in observational studies. The main advantages of NOACS such as "fixed-dose regimen" and "no need for regular anticoagulant therapy monitoring" may also be the Achilles heel of the use of these agents. Fixed-dose regimen may not be appropriate for elderly, for patients with chronic kidney disease, and for patients using interacting drugs. Adherence to NOAC therapy is another concern as it may be as low as 50 % in the chronic use of cardiovascular drugs, especially if the drug has no apparent affect to the patient. Thus, appropriate use of OACs among non-valvular AF (NVAF) patients is essential for stroke prophylaxis. We intended to review the use of OAC therapy among (NVAF) patients.

The available parenteral and oral anticoagulants have a large clinical use. Understanding biochemistry of anticoagulants may help to improve therapeutic strategies. Resistance to vitamin K antagonist drugs might be a problem for rodent populations. Patients who have thrombogenic risk factors should be anticoagulated. The need for cardiac implantable electronic devices is increasing, and there is a substantial number of patients who are on oral anticoagulant therapy. Prothrombin complex concentrate and other plasma concentrates are useful to deal with over-coagulated situations. The efficacy and safety of non-vitamin K antagonist oral anticoagulants have been proven in large phase III trials. The real-world data suggest even better outcomes with these agents compared to vitamin K antagonists.

This book is an essential guide to the medical treatment of thrombosis and presents core principles of anticoagulant therapeutics as well as drug recommendations. Written by recognized experts in the field, this concise, accessible handbook provides a unique and valuable resource in the cardiovascular field, both for those currently in training, and for those already in clinical or research practice.

This book describes new concepts and strategies for the clinical application of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke. Although vitamin K antagonists have traditionally been used for the prevention of stroke, there are some problems associated with their use, such as the risk of intracranial hemorrhage, the need for dietary restrictions, and individual variability. Recently, NOACs have been introduced as alternatives to traditional anticoagulants and are becoming an option for treating stroke patients around the globe. However, their use is not without risk. Each chapter describes the successful use of NOACs for stroke patients and discusses their future impact from various points of view. The book is primarily written for neurosurgeons and neurologists but is also of interest to cardiologists involved in stroke treatment.

Warfarin and related drugs have been used for over half a century in prevention and treatment of thrombotic disorders. Only recently however has their clinical role been firmly established by randomised studies and their benefit/risk ratio improved by lower dose therapy with improvements in laboratory monitoring. 'Oral Anticoagulants' is the first comprehensive, practical survey of the subject available. An international team of recognised experts provide detailed coverage on the mode of action; clinical pharmodynamics; magnitude and sources of variability in individuals response to oral anticoagulant; methods of individualising dosing regimens; laboratory monitoring; and comparison between the different currently prescribed oral anticoagulants.

This book concisely covers the latest developments in the application of direct oral anticoagulants (DOACs) within cardiovascular medicine. It details the pharmacodynamics and pharmacokinetic mechanisms of DOACs and their application in treating patients with conditions ranging from coronary heart disease through kidney disease and cancer, including their perioperative management. Direct Oral Anticoagulants: From Pharmacology to Clinical Practice systematically describes the underlying mechanisms associated with DOACs and their use to treat a range of conditions and is an indispensable resource for all trainee and practicing physicians in a range of disciplines seeking a concise up-to-date resource on the topic.