When Direct Oral Anticoagulants Should Not Be Standard Treatment

被引：32

作者：

Bejjani, Antoine ^{[1
,2
,3
]}

Khairani, Candrika D. ^{[1
,2
]}

Assi, Ali ^{[4
]}

Piazza, Gregory ^{[1
,2
,4
]}

Sadeghipour, Parham ^{[5
,6
]}

Talasaz, Azita H. ^{[7
,8
]}

Fanikos, John ^{[9
]}

Connors, Jean M. ^{[10
]}

Siegal, Deborah M. ^{[11
]}

Barnes, Geoffrey D. ^{[12
]}

Martin, Karlyn A. ^{[13
]}

Angiolillo, Dominick J. ^{[14
]}

Kleindorfer, Dawn ^{[15
]}

Monreal, Manuel ^{[16
]}

Jimenez, David ^{[17
]}

Middeldorp, Saskia ^{[18
,19
]}

Elkind, Mitchell S. V. ^{[20
,21
]}

Ruff, Christian T. ^{[2
]}

Goldhaber, Samuel Z. ^{[1
,2
]}

Krumholz, Harlan M. ^{[22
,23
,24
]}

Mehran, Roxana ^{[25
]}

Cushman, Mary ^{[26
,27
]}

Eikelboom, John W. ^{[28
]}

Lip, Gregory Y. H. ^{[29
,30
,31
]}

Weitz, Jeffrey I. ^{[32
,33
]}

Lopes, Renato D. ^{[34
,35
]}

Bikdeli, Behnood ^{[1
,2
,18
,19
,36
,37
]}

机构：

[1] Harvard Med Sch, Brigham & Womens Hosp, Thrombosis Res Grp, Boston, MA USA

[2] Harvard Med Sch, Brigham & Womens Hosp, Cardiovasc Med Div, Boston, MA USA

[3] Univ Pittsburgh, Med Ctr, Dept Med, Pittsburgh, PA USA

[4] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Boston, MA USA

[5] Iran Univ Med Sci, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran

[6] Iran Univ Med Sci, Clin Trial Ctr, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran

[7] Univ Tehran Med Sci, Tehran Heart Ctr, Tehran, Iran

[8] Virginia Commonwealth Univ, Richmond, VA USA

[9] Harvard Med Sch, Brigham & Womens Hosp, Dept Pharm, Boston, MA USA

[10] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Hematol Div, Boston, MA USA

[11] Univ Ottawa, Dept Med, Div Hematol, Ottawa, ON, Canada

[12] Univ Michigan, Frankel Cardiovasc Ctr, Dept Internal Med, Ann Arbor, MI USA

[13] Northwestern Univ, Feinberg Sch Med, Dept Med, Div Hematol & Oncol, Chicago, IL USA

[14] Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA

[15] Univ Cincinnati, Cincinnati, OH USA

[16] Univ Catolica San Antonio Murcia, Catedra Enfermedad Tromboembol, Murcia, Spain

[17] Univ Alcala, Hosp Ramon & Cajal, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Inst Ramon & Cajal Invest Sanitaria,Resp Dept, Madrid, Spain

[18] Univ Alcala, Ctr Invest Biomed Red Enfermedades Resp CIBERES, Inst Ramon & Cajal Invest Sanitaria, Med Dept, Madrid, Spain

[19] Radboud Univ Nijmegen, Med Ctr, Dept Internal Med, Nijmegen, Netherlands

[20] Vagelos Coll Phys & Surg, Dept Neurol, New York, NY USA

[21] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA

[22] Yale New Haven Hosp, Yale Ctr Outcomes Res & Evaluat, New Haven, CT USA

[23] Yale Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA

[24] Yale Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT USA

[25] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY USA

[26] Univ Vermont, Dept Med, Larner Coll Med, Burlington, VT USA

[27] Univ Vermont, Larner Coll Med, Dept Pathol & Lab Med, Burlington, VT USA

[28] McMaster Univ, Populat Hlth Res Inst, Hamilton Hlth Sci, Hamilton, ON, Canada

[29] Univ Liverpool, Liverpool John Moores Univ, Liverpool Ctr Cardiovasc Sci, Liverpool, England

[30] Liverpool Heart & Chest Hosp, Liverpool, England

[31] Aalborg Univ, Danish Ctr Clin Hlth Serv Res, Dept Clin Med, Aalborg, Denmark

[32] McMaster Univ, Hamilton, ON, Canada

[33] Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada

[34] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA

[35] Brazilian Clin Res Inst, Sao Paulo, Brazil

[36] Cardiovasc Res Fdn, New York, NY USA

[37] Brigham & Womens Hosp, Cardiovasc Med Div, 75 Francis St, Boston, MA 02115 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2024年 / 83卷 / 03期

基金：

美国国家卫生研究院;

关键词：

arterial thrombosis; bleeding; direct oral anticoagulants; randomized controlled trial; standard of care; venous thromboembolism; TOTAL KNEE ARTHROPLASTY; DEEP-VEIN THROMBOSIS; ATRIAL-FIBRILLATION; VENOUS THROMBOEMBOLISM; DABIGATRAN ETEXILATE; DOUBLE-BLIND; ANTIPHOSPHOLIPID SYNDROME; UNDETERMINED SOURCE; EXTENDED TREATMENT; CLINICAL-PRACTICE;

D O I：

10.1016/j.jacc.2023.10.038

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

For most patients, direct oral anticoagulants (DOACs) are preferred over vitamin K antagonists for stroke prevention in atrial fibrillation and for venous thromboembolism treatment. However, randomized controlled trials suggest that DOACs may not be as efficacious or as safe as the current standard of care in conditions such as mechanical heart valves, thrombotic antiphospholipid syndrome, and atrial fibrillation associated with rheumatic heart disease. DOACs do not provide a net benefit in conditions such as embolic stroke of undetermined source. Their efficacy is uncertain for conditions such as left ventricular thrombus, catheter -associated deep vein thrombosis, cerebral venous sinus thrombosis, and for patients with atrial fibrillation or venous thrombosis who have end -stage renal disease. This paper provides an evidence -based review of randomized controlled trials on DOACs, detailing when they have demonstrated efficacy and safety, when DOACs should not be the standard of care, where their safety and efficacy are uncertain, and areas requiring further research. (c) 2024 by the American College of Cardiology Foundation.

引用

页码：444 / 465

页数：22

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