New anticoagulant therapies in atrial fibrillation
Clinical outcomes
Keywords:
Adverse Drug Effects, Anticoagulant, Knowledge, Atrial Fibrillation, Clinical Outcomes, Pharmacists, ReviewAbstract
Background: Global observational studies are revealing a lack of agreement between recommendations and actual clinical practice when it comes to the dosages of direct oral anticoagulant drugs (DOACs). Aim of Work: This review provides a concise and critical assessment of the use of Direct Oral Anticoagulants (DOACs) in real-world clinical setting. Methods: This study was conducted using the PubMed (MEDLINE) and Medscape databases for the search. Results: Analysis of data from 75 trials revealed that the majority of patients who were administered DOACs for stroke prevention in atrial fibrillation were given dosages that aligned with the recommended recommendations. Nevertheless, a considerable proportion of patients were given dosages that were not approved for their specific condition (ranging from 25% to 50% in the majority of the assessed trials). Overdosing on DOACs was linked to higher rates of death from any cause and more severe bleeding episodes. Underdosing, on the other hand, was connected with higher rates of hospitalization for cardiovascular issues. Specifically, with apixaban, underdosing was linked to a nearly five times higher risk of stroke.
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