Evidence of novel oral anticoagulants (NOAC)

Novel oral anticoagulants (NOAC) such as the direct thrombin inhibitor, dabigatran, and oral factor Xa inhibitors, rivaroxaban and apixaban, have recently approved for prevention of stroke in nonvalvular atrial fibrillation (NVAF). Phase III trials have compared each of these agents to warfarin. Dabigatran was more efficacious than warfarin in reducing the risk of stroke when given at a dose of 150?mg BID to patients with NVAF. Rivaroxaban 20?mg QD was superior to warfarin in on-treatment analysis. Apixaban 5?mg BID was also found to be superior to warfarin in reducing stroke in NVAF patients. Of note, the rate of hemorrhagic stroke was much smaller in the patients treated with NOAC than those with warfarin. NOAC offer a good therapeutic option for prevention of stroke in NVAF patients.