Archives of the
Turkish Society of Cardiology
Review

The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics

1.

Department of Cardiology, Dokuz Eylül University School of Medicine, İzmir, Turkey

2.

Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey

3.

Department of Cardiology, Kartal Koşuyolu Heart and Research Institute, İstanbul, Turkey

4.

Department of Neurology, Hacettepe University School of Medicine, Ankara, Turkey

5.

Department of Gastroenterology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey

6.

Department of Neurology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey

7.

Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey

8.

Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey

9.

Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yüksek İhtisas Cardiovascular Building, Ankara City Hospital, Ankara, Turkey

10.

Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey

11.

Department of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

12.

Department of Cardiology, Bursa High Education Training and Research Hospital, Health Sciences University, Bursa, Turkey

13.

Department of Cardiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey

Archives of the Turkish Society of Cardiology 2022; 50: 356-370
DOI: 10.5543/tkda.2022.21191
Read: 130 Downloads: 49 Published: 01 July 2022

Data from Turkey revealed that atrial fibrillation patient percentage under adequate anti- coagulation in Turkey is less than that in other countries due to multiple parameters such as treatment adherence problems, failure to follow guideline recommendations, negative perspective on the use of new drugs, drug costs, and payment conditions. The aim of this article is to provide physicians with a compiled resource that focuses on the differences between non-vitamin K antagonist oral anticoagulants and heterogeneity of atrial fibrilla- tion patients by reviewing the global and national data from a multidisciplinary perspective and provide guidance on the choice of non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients. A gastroenterologist, 2 neurologists, and 11 cardiologists from university and training and research hospitals in Turkey who are experienced in atrial fibrillation and non-vitamin K antagonist oral anticoagulant treatments gathered in 3 separate meetings to identify the review topics and evaluate the outcomes of the systematic literature search. Based on the pharmacological characteristics, clinical studies, and real-world data compari- sons, it has been revealed that non-vitamin K antagonist oral anticoagulants are not similar. Thromboembolism and bleeding risks, renal and hepatic functions, coexisting conditions, and concomitant drug usage have been shown to affect the levels of benefits gained from non-vitamin K antagonist oral anticoagulant in atrial fibrillation patients. Although Turkish patients with atrial fibrillation have been observed to be younger, they are more likely to have coexisting cardiovascular conditions compared to the atrial fibrillation patients in other countries. Selection of an appropriate non-vitamin K antagonist oral anticoagulant in line with the available evidence and recent guidelines will provide substantial benefits to atrial fibrillation patients.

Cite this article as: Ergene O, Aras D, Kaymaz C, et al. The Role of Non- Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Turk Kardiyol Dern Ars 2022;50(5):356-370.

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ISSN 1016-5169 EISSN 1308-4488