{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:36:58Z","timestamp":1782603418528,"version":"3.54.5"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban and rivaroxaban, which inhibit factor Xa. In large clinical trials comparing the NOACs with the vitamin K antagonist (VKA) warfarin, dabigatran, apixaban, rivaroxaban and edoxaban were at least as effective for stroke prevention in atrial fibrillation and for treatment of venous thromboembolism, but were associated with less intracranial bleeding. In addition, the NOACs are more convenient to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring. Consequently, the NOACs are now replacing VKAs for these indications, and their use is increasing. Although, as a class, the NOACs have a favourable benefit\u2013risk profile compared with VKAs, choosing among them is complicated because they have not been compared in head-to-head trials. Therefore, selection depends on the results of the individual trials, renal function, the potential for drug\u2013drug interactions and preference for once- or twice-daily dosing. In addition, several \u2018special situations\u2019 were not adequately studied in the dedicated clinical trials. For these situations, knowledge of the unique pharmacological features of the various NOACs and judicious cross-trial comparison can help inform prescription choices. The purpose of this position article is therefore to help clinicians choose the right anticoagulant for the right patient at the right dose by reviewing a variety of special situations not widely studied in clinical trials.<\/jats:p>","DOI":"10.1055\/s-0038-1675816","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T23:31:15Z","timestamp":1546299075000},"page":"014-038","source":"Crossref","is-referenced-by-count":28,"title":["The Non-Vitamin K Antagonist Oral Anticoagulants in Heart Disease: Section V\u2014Special Situations"],"prefix":"10.1055","volume":"119","author":[{"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Institute of Cardiology and Center of Excellence on Aging, G. d'Annunzio University of Chieti\u2013Pescara, Pescara, Italy"},{"name":"University Cardiology Division, University of Pisa, Pisa University Hospital, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Ageno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Agnelli","sequence":"additional","affiliation":[{"name":"Department of Vascular Emergency Medicine\u2013Stroke Unit, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Chan","sequence":"additional","affiliation":[{"name":"Thrombosis and Atherosclerosis Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Christoph","family":"Diener","sequence":"additional","affiliation":[{"name":"Department of Neurology, Essen University Hospital, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Hylek","sequence":"additional","affiliation":[{"name":"Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston University, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Raskob","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Siegal","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freek","family":"Verheugt","sequence":"additional","affiliation":[{"name":"Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Weitz","sequence":"additional","affiliation":[{"name":"Thrombosis and Atherosclerosis Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,12,31]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1675816.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T21:13:24Z","timestamp":1557177204000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1675816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,31]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,12,31]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1675816","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,31]]}}}