Oral Anticoagulation and the Novel Oral Anticoagulants (NOACs):Where Are We at Midterm?

Academic Content

Program Overview

Faculty Presentations

Introduction Deepak L. Bhatt Elaine Hylek

Video Roundtable

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Deepak L. Bhatt, MD, MPH
Interventional Cardiovascular Programs
Brigham & Women’s Hospital
Heart & Vascular Center
Harvard Medical School
Boston, Massachusetts

Overview: Anticoag & NOACs AFib Impact AFib in the USA AFib: Age Prevalence AFib: Age & Gender AFib: Age & Strokes Problems with Warfarin Warfarin INR Values & Stroke CHADS2 & AFib - Index Scores CHADS2 & AFib - Patient Scores The REACH Registry: CVD Events CHA2DS2-VASc Stroke Risk The HAS-BLED Risk Score Markov Decision Analysis Novel Oral Anticoagulants NOACS: Risk Prevention Data NOACS: Secondary Efficacy NOACS: Major Bleeding NOACS: Secondary Safety Potentially Preventable Strokes Anticoagulation in VTE Regulatory Approval Status

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The NOACS: Secondary Safety Outcomes

Continuing with the same meta-analysis as in the previous Figures,[17] looking at secondary safety outcomes, there appears to be a definite difference between the specific bleeding outcomes. There was a clear reduction, about 50%, in intracranial hemorrhage (ICH) with all of the NOACs in the trials. On the other hand, there also appears to be a significant excess in gastrointestinal (GI) bleeding with these agents, compared with warfarin.

Bhatt D. Am J Med 2014; 00.

References

[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 randomised trials. Lancet. 2014;383:955-962.