Alternatives to WarfarinuThe Next Generation of Anticoagulants

作者：Kanagasabapathy Pamala; Chowdary Pratima; Gatt Alex^*

来源：Cardiovascular Therapeutics, 2011, 29(6): E80-E88.

DOI：10.1111/j.1755-5922.2010.00197.x

• Coagulation
• Thrombosis
• Direct Xa inhibitors
• Thrombin inhibitors
• Vitamin K antagonists
• Warfarin

Anticoagulation therapy plays an important role in the management of cardiovascular disease. Currently, oral anticoagulation therapy is reliant on vitamin K antagonists (VKA). In clinical practice, VKA present several limitations including a narrow therapeutic window and frequent drug and food interactions. Despite the clear clinical need for alternative anticoagulants it is only within the last decade that significant progress has been made. These new anticoagulants target specific factors in the hemostatic network and appear to overcome some of the difficulties seen with VKA. Many have now progressed to phase III clinical trials including patients with cardiovascular disease. This review aims to highlight the exciting progress that has been made in the development of these new anticoagulants. It will focus on the key agents that have demonstrated the most promise in clinical trials to date. This will include data on cardiovascular indications for anticoagulant therapy. Finally, the review aims to analyze the future prospects for these new agents. Several issues remain to be addressed for these agents to finally replace vitamin K antagonists as the mainstay of anticoagulant therapy.

• 出版日期2011