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Medicina
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Guidelines, New Data and Real-World Evidence with Oral Anticoagulants
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Guidelines, New Data and Real-World Evidence with Oral Anticoagulants

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (26 January 2023) | Viewed by 8626

Special Issue Editor

Dr. Giuseppe Andò

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
Interests: oral anticoagulants (OAC); atrial fibrillation; acute coronary syndrome; percutaneous coronary intervention (PCI); guidelines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There has been considerable progress in the pharmacology of oral anticoagulants (OAC) over the last twenty years, and non-vitamin K antagonists OAC (NOAC) have dramatically changed clinical practice. NOAC have demonstrated a favorable risk–benefit profile in patients with atrial fibrillation and with venous thromboembolism in phase III trials, although real-world evidence highlights that several issues in the implementation of NOAC in clinical practice still remain unresolved in specific subsets. On the other hand, re-emerging concepts on the pathophysiology of atherothrombosis have paved the way for a new therapeutic option consisting in the association of antiplatelet and low-dose NOAC, known as dual pathway inhibition. While guidelines issued by scientific societies summarize and evaluate available evidence to facilitate clinicians in their decision making for daily practice, continuously evolving research introduces new diagnostic algorithms and challenges therapeutic concepts. The present Special Issue has been thought to provide an overview of the latest evidence in the field of OAC focusing on both diagnostic and therapeutic advances and highlighting their implications for patients’ prognosis. Therefore, we welcome the submission of review articles as well as original research papers dealing with the topics of guidelines, new data, and real-world evidence about OAC in atrial fibrillation, atherothrombosis, and venous thromboembolism.

Dr. Giuseppe Andò
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral anticoagulants (OAC)
  • atrial fibrillation
  • stroke
  • venous thromboembolism (VTE)
  • dual pathway inhibition (DPI)
  • coronary artery disease (CAD)
  • peripheral artery disease (PAD)
  • real-world evidence (RWE)

Published Papers (2 papers)

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Review

14 pages, 1110 KiB  
Review
Use of Anticoagulant Therapy in Patients with Acute Myocardial Infarction and Atrial Fibrillation
by Ratko Lasica, Lazar Djukanovic, Dejana Popovic, Lidija Savic, Igor Mrdovic, Nebojsa Radovanovic, Mina Radosavljevic Radovanovic, Marija Polovina, Radan Stojanovic, Dragan Matic, Ana Uscumlic and Milika Asanin
Medicina 2022, 58(3), 338; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58030338 - 23 Feb 2022
Cited by 1 | Viewed by 4907
Abstract
The incidence of atrial fibrillation (AF) in acute coronary syndrome (ACS) ranges from 2.3–23%. This difference in the incidence of AF is explained by the different ages of the patients in different studies and the different times of application of both reperfusion and [...] Read more.
The incidence of atrial fibrillation (AF) in acute coronary syndrome (ACS) ranges from 2.3–23%. This difference in the incidence of AF is explained by the different ages of the patients in different studies and the different times of application of both reperfusion and drug therapies in acute myocardial infarction (AMI). About 6–8% of patients who underwent percutaneous intervention within AMI have an indication for oral anticoagulant therapy with vitamin K antagonists or new oral anticoagulants (NOAC).The use of oral anticoagulant therapy should be consistent with individual risk of bleeding as well as ischemic risk. Both HAS-BLED and CHA2DS2VASc scores are most commonly used for risk assessment. Except in patients with mechanical valves and antiphospholipid syndrome, NOACs have an advantage over vitamin K antagonists (VKAs). One of the advantages of NOACs is the use of fixed doses, where there is no need for successive INR controls, which increases the patient’s compliance in taking these drugs. The use of triple therapy in ACS is indicated in the case of patients with AF, mechanical valves as well as venous thromboembolism. The results of the studies showed that when choosing a P2Y12 receptor blocker, less potent P2Y12 blockers such as Clopidogrel should be chosen, due to the lower risk of bleeding. It has been proven that the presence of AF within AMI is associated with a higher degree of reinfarction, more frequent stroke, high incidence of heart failure, and there is a correlation with an increased risk of sudden cardiac death. With the appearance of AF in ACS, its rapid conversion into sinus rhythm is necessary, and in the last resort, good control of heart rate in order to avoid the occurrence of adverse clinical events. Full article
(This article belongs to the Special Issue Guidelines, New Data and Real-World Evidence with Oral Anticoagulants)
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13 pages, 742 KiB  
Review
Oral Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease
by Mihai Ciprian Stoica, Zsolt Gáll, Mirela Liana Gliga, Carmen Denise Căldăraru and Orsolya Székely
Medicina 2021, 57(5), 422; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050422 - 27 Apr 2021
Cited by 4 | Viewed by 2820
Abstract
Over the past few decades, a series of innovative medicines have been developed in order to optimize anticoagulation therapy for atrial fibrillation (AF). As a result, a number of nonvitamin K antagonist oral anticoagulants (NOAC) that directly target the enzymatic activity of factor [...] Read more.
Over the past few decades, a series of innovative medicines have been developed in order to optimize anticoagulation therapy for atrial fibrillation (AF). As a result, a number of nonvitamin K antagonist oral anticoagulants (NOAC) that directly target the enzymatic activity of factor II and factor Xa have been successfully licensed providing a more predictable effect and better safety profile compared to conventional anticoagulants (heparins and vitamin K antagonists (VKAs)). However, comparative efficacy and safety data is limited in patients with advanced chronic kidney disease (i.e., CKD stage 4/5 and end stage renal disease) because patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 were actively excluded from landmark trials, thus representing a major clinical limitation for the currently available agents. However, the renal function of AF patients can be altered over time. On the other hand, patients with CKD have an increased risk of developing AF. This review article will provide an overview of current concepts and recent evidence guiding the clinical use of NOACs in patients with CKD requiring chronic anticoagulation, and the associated risks and benefits of treatment in this specific patient population. Full article
(This article belongs to the Special Issue Guidelines, New Data and Real-World Evidence with Oral Anticoagulants)
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