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Open Access The Use of Direct Oral Anticoagulants for Prevention of Stroke and Systemic Embolic Events in East Asian Patients with Nonvalvular Atrial Fibrillation

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

As patients in East Asia age, the prevalence of age-related and chronic disease, including nonvalvular atrial fibrillation, may increase. Although warfarin has been the primary choice of anticoagulant for the prevention of stroke and systemic embolic events, the use of direct oral anticoagulants (DOACs) is increasing. DOACs do not require monitoring of the international normalized ratio to determine the optimal dose, and have a lower potential for food and drug interactions, improved benefit-risk profiles, and a quicker onset and offset of action relative to warfarin. The pivotal phase 3 trials for each of the DOACs ‐ dabigatran, rivaroxaban, apixaban, and edoxaban ‐ included at least some East Asian patients. Additionally, several clinical trials were conducted specifically for East Asian patients. This review discusses patterns and predictors of anticoagulant use in East Asian patients with nonvalvular atrial fibrillation, summarizes current guideline recommendations for East Asian patients, details the primary results demonstrating the safety and efficacy of DOACs in East Asian patients relative to non‐East Asian patients, provides real-world data supporting the phase 3 testing results, and addresses the clinical profile of DOACs in East Asian populations, including patients at high risk of stroke.
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Keywords: East Asia; anticoagulant; direct oral anticoagulant; stroke

Document Type: Research Article

Publication date: July 1, 2018

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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