newer anticoagulants for non-valvular atrial fibrillation更新为non-valvular房颤抗凝血剂.pdfVIP

Pharmaceuticals 2012, 5, 469-480; doi:10.3390/ph5050469 OPEN ACCESS Pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Newer Anticoagulants for Non-Valvular Atrial Fibrillation Joseph M. Harburger and Wilbert S. Aronow * Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA * Author to whom correspondence should be addressed; E-Mail: wsaronow@; Tel.: +1-914-493-5311; Fax: +1-914-235-6274. Received: 29 March 2012; in revised form: 28 April 2012 / Accepted: 28 April 2012 / Published: 4 May 2012 Abstract: Non-valvular atrial fibrillation is a recognized risk factor for stroke and systemic embolism. It has been clearly established that warfarin reduces the risk of stroke and systemic embolism in persons with atrial fibrillation and additional risk factors for stroke. The use of warfarin, however, requires frequent monitoring, and there is great variability in patient response to warfarin. Warfarin interacts with several medications and foods. In addition, warfarin use portends a significant risk of bleeding. For these reasons, warfarin is frequently not prescribed to persons for whom the drug would provide a clear benefit. Over the past decade, attempts have been made to develop drugs that are at least as safe and effective as warfarin for the treatment of atrial fibrillation that do not require monitoring nor have as many interactions. Initial studies of compounds in this regard ultimately failed