Non-vitamin K oral anticoagulants (NOAC) and the risk of myocardial infarction: Differences between factor IIa and factor Xa inhibition?

Amin Polzin, Lisa Dannenberg, Georg Wolff, Carolin Helten, Alina Achilles, Thomas Hohlfeld, Tobias Zeus, Malte Kelm, Steffen Massberg, Tobias Petzold

Journal: Pharmacology & therapeutics 2020;195():1-4

PMID: 30321554

Full Text on Elsevier Science View on PubMed

Abstract

Guidelines already recommend non-vitamin K oral anticoagulants (NOAC) over vitamin-K antagonists (VKA) for stroke prevention in patients with atrial fibrillation. However, recommendations are lacking with respect to which NOAC to use. At the moment, NOACs may employ two different molecular mechanisms: Factor IIa inhibition (dabigatran) and factor Xa inhibition (apixaban, edoxaban, rivaroxaban). The focus of this review is to compare and contrast potential differences between factor IIa- and factor Xa inhibition with respect to risk of myocardial infarction and to detail underlying mechanisms.

Address: Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany.; Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany. Electronic address: [email protected].; Instituton of Pharmacology and Clinical Pharmacology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.; Department of Cardiology, LMU München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance, Munich, Germany.

DOI: 10.1016/j.pharmthera.2018.10.005

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MeSH Terms: Administration, Oral, Anticoagulants, Atrial Fibrillation, Factor Xa, Humans, Myocardial Infarction, Prothrombin, Risk, Stroke