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Neurol India. 2019 Sep-Oct;67(5):1200-1212. doi: 10.4103/0028-3886.271256.

Critical Issues and Recent Advances in Anticoagulant Therapy: A Review.

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Department of Pharmacology, Maulana Azad Medical College, New Delhi, India.
Department of Pharmacology, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India.


As the population is aging, clinicians are coming across more patients with atrial fibrillation and venous thromboembolism requiring anticoagulation to prevent stroke and systemic embolisms. Due to a high prevalence and unfavorable consequences, managing thromboembolic diseases have become areas of clinical concern. Traditional anticoagulants like heparin, low molecular weight heparin and warfarin have been used for the prevention and treatment of venous and arterial thromboses. But, issues of bleeding, parenteral route of administration, or the need for frequent monitoring due to variability in response respectively limit their use. The article gives an overview of coagulation along with existing therapy available for anticoagulation and to present an update on utility and recent advances of new oral anticoagulants (NOACs) beginning from their nomenclature, advantages, disadvantages, precautions and contraindications compared with those of vitamin K antagonists (VKAs) based on a large number of recent studies and clinical trials.


Atrial fibrillation; new oral anticoagulants; venous thromboembolism; vitamin K antagonist

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