ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
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]
Turk Kardiyol Dern Ars. 2022; 50(5): 356-370 | DOI: 10.5543/tkda.2022.21191

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

Asim Oktay Ergene1, Dursun Aras2, Cihangir Kaymaz3, Ethem Murat Arsava4, Can Gönen5, Erdem Gürkaş6, Uğur Arslan7, Göksel Çağırıcı8, Serkan Çay9, Mustafa Kılıçkap10, Selçuk Kanat11, Ebru Özpelit12, Fahriye Vatansever13, Kadriye Kılıçkesmez14
1Department of Cardiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
2Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
3Department of Cardiology, Kartal Koşuyolu Heart and Research Institute, İstanbul, Turkey
4Department of Neurology, Hacettepe University School of Medicine, Ankara, Turkey
5Department of Gastroenterology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
6Department of Neurology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
7Department of Cardiology, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
8Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
9Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yüksek İhtisas Cardiovascular Building, Ankara City Hospital, Ankara, Turkey
10Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
11Department of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
12Department of Cardiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
13Department of Cardiology, Bursa High Education Training and Research Hospital, Health Sciences University, Bursa, Turkey
14Department of Cardiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey

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 fibrillation 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 comparisons, 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.

Keywords: Apixaban, dabigatran, DOACs, edoxaban, NOACs, rivaroxaban

How to cite this article
Asim Oktay Ergene, Dursun Aras, Cihangir Kaymaz, Ethem Murat Arsava, Can Gönen, Erdem Gürkaş, Uğur Arslan, Göksel Çağırıcı, Serkan Çay, Mustafa Kılıçkap, Selçuk Kanat, Ebru Özpelit, Fahriye Vatansever, Kadriye Kılıçkesmez. 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

Corresponding Author: Asim Oktay Ergene
Manuscript Language: English


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