Review Article Non-Vitamin K antagonist Oral Anticoagulants (NOAC) in Atrial Fibrillation (AF).

NOAC and AF Bombay

Abstract

Atrial Fibrillation (AF) is the most common supraventricular tachycardia resulting in hospitalization and morbidity. Patients with AF are anticoagulated to reduce stroke risk. However, majority of them are not properly anticoagulated or not treated.  Vitamin K antagonist were developed mainly to reduce the patients clotting risk but required therapeutic monitoring and had multiple drug interaction. Many studies have found NOACs to be as effective as Warfarin in reducing stroke and embolism by reducing intra cranial bleed. So, this article explores the physicians reason for under treatment and focusing on the role of NOACs as per indications. The first step in all AF patients is to see whether AF is valvular or non-valvular. If valvular than only Vitamin K antagonist Oral Anticoagulants can be used and if non-valvular NOACs can be used. In present article we review the role of different NOACs in management of non-valvular AF and their antidotes. We also focus on when, where and how long NOACs to be given. Latest guidelines also recommend increased NOAC use in non-valvular AF mainly to reduce or prevent mortality and morbidity.