Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile of the NOACs regarding the hemorrhagic risk is superior to vitamin K antagonists, the problem raised by an unexpected hemorrhage (e.g. severe hemorrhage after an accident) and the need for efficient hemostasis in a chronic anticoagulated patient has remained unsolved. To find a solution for this problem, reversal agents for NOACs have been developed and tested, and two of them, idarucizumab and andexanet-alpha, have already been approved by the FDA, thus making NOACs increasingly appealing as a choice of anticoagulation treatment.
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Laslo, Crista L.; Pantea Stoian, Anca; Socea, Bogdan; Paduraru, Dan N.; Bodean, Oana; Socea, Laura I.; Neagu, Tiberiu P.; Stanescu, Ana Maria Alexandra; Marcu, Dragos; and Diaconu, Camelia C.
"New oral anticoagulants and their reversal agents,"
Journal of Mind and Medical Sciences: Vol. 5:
2, Article 9.
Available at: https://scholar.valpo.edu/jmms/vol5/iss2/9