New Anticoagulants in the Treatment of Atrial Fibrillation in 2011

摘要: In the last 60 years antivitamin K antagonists (AVK) represented only effective medication for long-term treatment of venous thromboembolism (VTE) and stroke prevention in valvular non-valvular atrial fibrillation (AF). Although effective, anticoagulant effect AVK is non- predictable, with narrow therapeutic window (INR between 2 3 AF) has multiple interactions drugs food requiring repeated laboratory monitoring coagulation parameters (INR). addition, resistance to registered about 10% cases. Extensive research over 5-10 on processes thrombosis, both arterial venous, focused two major factors anticoagulation cascade: factor X activated II (FII FXa). They have become targets. At present, three new molecules (dabigatran, rivaroxaban, apixaban) extensive programs are various moments approval by FDA (Food Drug Administration) EMA (European Medicine Agency, name EMEA). Currently, indication antithrombotic AF determined relation risk (risk stratification) using CHA2DS2 or CHADS2-VASc scores. The risks bleeding HAS-BLED score; recently it been shown that embolic scores (CHADS2 CHA2DS2-VASc) useful also determining hemorrhage (approx. 2%/year patients treated AVK). Recommendations thromboprophylaxis updated recent Atrial Fibrillation Management Guide (ESC 2010) (1).