Abstract:

The global burden of atrial fibrillation remains high. The approval of several novel oral anticoagulant agents (NOACs) as well as of idarucizumab for dabigatran reversal and andexanet-alpha for factor Xa-inhibitors represent landmark developments in the NOAC field. Although NOACs have also shown a positive net clinical benefit, even in patients with one additional stroke risk factor, clinical practice challenges persist. NOAC therapy is often underused in eligible patients despite clear recommendations in international guidelines.Moreover, it remains challenging to implement appropriate strategies for reversing NOACs in emergency settings. A symposium, How NOAC Selection and Reversal Can Help Protect Our Patients: Your Questions Answered, was held during the 5th European Stroke Organization Conference in May 2019 in Milan, Italy. This symposium reviewed advances in anticoagulation, including: NOAC selection; dosing strategies; evidence concerning anticoagulation reversal strategies; and strategies for using reversal agents before surgery, in patients with intracerebral hemorrhage, and in patients presenting with ischemic stroke prior to thrombolysis.

 

Acknowledgements: Manuscript preparation provided by Thistle Editorial, LLC

Keywords:

Atrial Fibrillation, Ich, Noacs, Dabigatran, Reversal Agents, Idarucizumab