The Role of Non-Vitamin K Antagonist Oral
Anticoagulants (NOACs) in Atrial Fibrillation:
Treatment Management Based on Patient and Drug
Characteristics

The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics

Öz:

Data from Turkey revealed that atrial fibrillation patient percentage under adequate anticoagulation in Turkey is less than that in other countries due to multiple parameters such as treatment adherence problems, failure to follow guideline recommendations, negative perspective on the use of new drugs, drug costs, and payment conditions. The aim of this article is to provide physicians with a compiled resource that focuses on the differences between non-vitamin K antagonist oral anticoagulants and heterogeneity of atrial fibrillation patients by reviewing the global and national data from a multidisciplinary perspective and provide guidance on the choice of non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients. A gastroenterologist, 2 neurologists, and 11 cardiologists from university and training and research hospitals in Turkey who are experienced in atrial fibrillation and non-vitamin K antagonist oral anticoagulant treatments gathered in 3 separate meetings to identify the review topics and evaluate the outcomes of the systematic literature search. Based on the pharmacological characteristics, clinical studies, and real-world data comparisons, it has been revealed that non-vitamin K antagonist oral anticoagulants are not similar. Thromboembolism and bleeding risks, renal and hepatic functions, coexisting conditions, and concomitant drug usage have been shown to affect the levels of benefits gained from non-vitamin K antagonist oral anticoagulant in atrial fibrillation patients. Although Turkish patients with atrial fibrillation have been observed to be younger, they are more likely to have coexisting cardiovascular conditions compared to the atrial fibrillation patients in other countries. Selection of an appropriate non-vitamin K antagonist oral anticoagulant in line with the available evidence and recent guidelines will provide substantial benefits to atrial fibrillation patients.

Anahtar Kelime:

Non-vitamin K Antagonisti Oral Antikoagülanların (NOAK) Atriyal Fibrilasyon Klinik Pratiğindeki Yeri: Hasta ve İlaç Özelliklerine Göre Tedavi Yönetimi

Öz:

Türkiye verileri atriyal fibrilasyon hastalarının yeterli antikoagulan tedavi alma oranlarının; tedaviye uyum problemleri, kılavuz önerilerinin gerektiği gibi takip edilmemesi, yeni ilaçların kullanımına negatif bakış açısı, ilaç maliyetleri ve ödeme koşulları gibi nedenlerden dolayı diğer ülkelere kıyasla daha az olduğunun altını çizmektedir. Bu yayının amacı global ve ulusal yayınları non-vitamin K Antagonisti oral antikoagülanların ve atriyal fibrilasyon hastalarının farklı özellikleri odağında gözden geçirerek, Türkiye’deki hekimlere multisidipliner bakış açısıyla hasta özelliklerine uygun non-vitamin K Antagonisti oral antikoagülan seçimlerinde yol gösterebilecek güncel ve kapsamlı bir kaynak sunmaktır. Türkiye’deki üniversite ve eğitim araştırma hastanelerinde görev yapan, atriyal fibrilasyon ve non-vitamin K Antagonisti oral antikoagülan tedavilerinde deneyim sahibi, bir gastroenteroloji, iki nöroloji ve on bir kardiyoloji uzmanı üç ayrı toplantıda bir araya geldi, derleme çalışmasında irdelenecek konu başlıkları belirleyip ardından sistematik literatür taramasının sonuçlarını değerlendirerek çalışmayı gerçekleştirdi. Farmakolojik yapıları, klinik çalışma ve gerçek yaşam verileri ile non-vitamin K Antagonisti oral antikoagülanların farklı özelliklere sahip oldukları ortaya konuldu. Hastalara ait inme ve kanama risklerinin, böbrek ve karaciğer fonksiyonlarının, atriyal fibrilasyona eşlik eden diğer hastalıkların ve eş zamanlı kullanılan çeşitli tedavilerin non-vitamin K Antagonisti oral antikoagülan tedavilerinden elde edilecek faydaları etkileyebileceği görüldü. Türkiye’deki non-vitamin K Antagonisti oral antikoagülan kullanan atriyal fibrilasyon hastalarının diğer ülkelerdeki hastalara göre daha genç bir yaş ortalamasına sahip olduğu bunun yanısıra atriyal fibrilasyona eşlik eden kardiyovasküler hastalıklarının da daha fazla olduğu gözlemlendi. Mevcut kanıtlar ışığında ve güncel kılavuzlara uygun olarak yapılacak non-vitamin K Antagonisti oral antikoagülan seçimi atriyal fibrilasyon hastalarına anlamlı faydalar sağlayacaktır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	Ergene A, Aras D, Kaymaz C, Arsava E, Gönen C, Gürkaş E, Arslan U, Cagirci G, KILICKAP M, Cay S, KANAT S, Özpelit E, Vatansever F, Kilickesmez K (2022). The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. , 356 - 370. 10.5543/tkda.2022.21191
Chicago	Ergene Asim Oktay,Aras Dursun,Kaymaz Cihangir,Arsava Ethem Murat,Gönen Can,Gürkaş Erdem,Arslan Uğur,Cagirci Goksel,KILICKAP MUSTAFA,Cay Serkan,KANAT SELCUK,Özpelit Ebru,Vatansever Fahriye,Kilickesmez Kadriye The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. (2022): 356 - 370. 10.5543/tkda.2022.21191
MLA	Ergene Asim Oktay,Aras Dursun,Kaymaz Cihangir,Arsava Ethem Murat,Gönen Can,Gürkaş Erdem,Arslan Uğur,Cagirci Goksel,KILICKAP MUSTAFA,Cay Serkan,KANAT SELCUK,Özpelit Ebru,Vatansever Fahriye,Kilickesmez Kadriye The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. , 2022, ss.356 - 370. 10.5543/tkda.2022.21191
AMA	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. . 2022; 356 - 370. 10.5543/tkda.2022.21191
Vancouver	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. . 2022; 356 - 370. 10.5543/tkda.2022.21191
IEEE	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K "The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics." , ss.356 - 370, 2022. 10.5543/tkda.2022.21191
ISNAD	Ergene, Asim Oktay vd. "The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics". (2022), 356-370. https://doi.org/10.5543/tkda.2022.21191

APA	Ergene A, Aras D, Kaymaz C, Arsava E, Gönen C, Gürkaş E, Arslan U, Cagirci G, KILICKAP M, Cay S, KANAT S, Özpelit E, Vatansever F, Kilickesmez K (2022). The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Türk Kardiyoloji Derneği Arşivi, 50(5), 356 - 370. 10.5543/tkda.2022.21191
Chicago	Ergene Asim Oktay,Aras Dursun,Kaymaz Cihangir,Arsava Ethem Murat,Gönen Can,Gürkaş Erdem,Arslan Uğur,Cagirci Goksel,KILICKAP MUSTAFA,Cay Serkan,KANAT SELCUK,Özpelit Ebru,Vatansever Fahriye,Kilickesmez Kadriye The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Türk Kardiyoloji Derneği Arşivi 50, no.5 (2022): 356 - 370. 10.5543/tkda.2022.21191
MLA	Ergene Asim Oktay,Aras Dursun,Kaymaz Cihangir,Arsava Ethem Murat,Gönen Can,Gürkaş Erdem,Arslan Uğur,Cagirci Goksel,KILICKAP MUSTAFA,Cay Serkan,KANAT SELCUK,Özpelit Ebru,Vatansever Fahriye,Kilickesmez Kadriye The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Türk Kardiyoloji Derneği Arşivi, vol.50, no.5, 2022, ss.356 - 370. 10.5543/tkda.2022.21191
AMA	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Türk Kardiyoloji Derneği Arşivi. 2022; 50(5): 356 - 370. 10.5543/tkda.2022.21191
Vancouver	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Türk Kardiyoloji Derneği Arşivi. 2022; 50(5): 356 - 370. 10.5543/tkda.2022.21191
IEEE	Ergene A,Aras D,Kaymaz C,Arsava E,Gönen C,Gürkaş E,Arslan U,Cagirci G,KILICKAP M,Cay S,KANAT S,Özpelit E,Vatansever F,Kilickesmez K "The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics." Türk Kardiyoloji Derneği Arşivi, 50, ss.356 - 370, 2022. 10.5543/tkda.2022.21191
ISNAD	Ergene, Asim Oktay vd. "The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics". Türk Kardiyoloji Derneği Arşivi 50/5 (2022), 356-370. https://doi.org/10.5543/tkda.2022.21191