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Comparative analysis of oral anticoagulants (vitamin K antagonists and new drugs, including dabigatran, rivaroxaban and apixaban) is presented from the standpoint of safety. The safety profile of the new oral anticoagulants is significantly better than vitamin K antagonists profile, but requires consideration of special clinical situations that predispose to an increased risk of bleeding.

About the Authors

D. A. Napalkov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Trubetskaya ul. 8-2, Moscow, 119991 Russia

A. A. Sokolova
I.M. Sechenov First Moscow State Medical University
Russian Federation
Trubetskaya ul. 8-2, Moscow, 119991 Russia


1. Camm AG, Lip GYH, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2012; 33: 2719-2747.

2. National guidelines for diagnosis and treatment of atrial fibrillation (2012). Available at: Accessed by 04/28/2014. Russian (Национальные рекомендации по диагностике и лечению фибрилляции предсердий (2012). Доступно на: Проверено 28.04.2014).

3. Lip GYH, Frison L, Grind M on behalf of the SPORTIF Investigators. Effects of hypertension on anticoagulated patients with atrial fibrillation. Eur Heart J 2007; 28: 752-9.

4. Mammen EF. Coagulation abnormalities in liver disease. Hematol Oncol Clin North Am 1992; 6: 1247-57.

5. Landefeld CS, Cook EF, Flatley M, et al. Identification and preliminary validation of predictors of major bleeding in hospitalized patients starting anticoagulant therapy. Am J Med 1987; 82: 703-13.

6. Brigden ML, Kay C, Le A et al. Audit of the frequency and clinical response to excessive oral anticoagulation in an outpatient population. Am J Hematol 1998; 59: 22-7.

7. Graff J, Harder S. Anticoagulant therapy with the oral direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban and the thrombin inhibitor dabigatran etexilate in patients with hepatic impairment. Clin Pharmacokinet 2013; 52 (4): 243-54.

8. Soliman EZ, Prineas RJ, Go AS, et al. Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J 2010; 159: 1102-1107.

9. Fox KA, Piccini JP, Wojdyla D, A et al. Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment. Eur Heart J 2011; 32: 2387-94.

10. Granger CB, Alexander JH, McMurray JJ, et al. for the ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981-92.

11. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-51.

12. Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the Randomized Evaluation of Long-term Anticoagulant therapy (RE-LY) Trial. Circulation 2011; 123: 2363-72.

13. Hart RG, Eikelboom JW, Ingram AJ, Herzog CA. Anticoagulants in atrial fibrillation patients with chronic kidney disease. Nat Rev Nephrol 2012; 8: 569-78.

14. Loke YK, Pradhan S, Yeong JK, Kwok CS. Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparisons. Br J Clin Pharmacol 2014; Mar 11. doi: 10.1111/bcp.12376.

15. Mak K-H. Coronary and mortality risk of novel oral antithrombotic agents: a meta-analysis of large randomized trials. BMJ Open 2012; 2:e001592. doi: 10.1136/bmjopen-2012-001592.

16. Wasserlauf G, Grandi SM, Filion KB, Eisenberg MJ. Meta-analysis of rivaroxaban and bleeding risk. Am J Cardiol 2013;112(3):454-60.

17. Ruff CT, Giugliano RP, Braunwald E et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomized trials. Lancet 2014;383(9921):955-62.


For citations:

Napalkov D.A., Sokolova A.A. NEW ORAL ANTICOAGULANTS: FOCUS ON THE SAFETY. Rational Pharmacotherapy in Cardiology. 2014;10(4):444-447. (In Russ.)

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ISSN 1819-6446 (Print)
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