Abstract
Atrial fibrillation (AF), one of the most prevalent supra-ventricular arrhythmia in adults, is related to a substantial increase in the risk of thromboembolic events requiring tailored preventive strategy. In AF, antithrombotic therapy should be individualized according to a careful decisionmaking process, taking in account the likely concomitant presence of risk factors for stroke and bleeding. Anticoagulation management is particularly challenging in women with AF, to the extent that female sex is incorporated in commonly used stratification schemes for both thromboembolic and bleeding risk evaluation. Nevertheless, gender- based differences on the efficacy and safety of either “old” (i.e. vitamin K antagonist) or “new” oral anticoagulants (i.e. direct thrombin inhibitors and activated factor X inhibitors) are not conclusive and not always reported. This review aims to analyse the literature on sex differences in AF anticoagulation management. We focus on safety data, bleeding complications and specific haemostatic mechanisms currently under investigation, which could account for observed disparities among sexes. Moreover, details on sex difference in response to anticoagulant treatment will be discussed. Comparing old and new antithrombotics, a need clearly emerges for differentiated and integrated strategies for the treatment of AF in female patients.
Keywords: Atrial fibrillation, anticoagulant therapy, gender differences, new oral anticoagulants.
Current Vascular Pharmacology
Title:Old And New Oral Anticoagulants In Management Of Atrial Fibrillation: A Double-Edged Sword For Women
Volume: 13 Issue: 6
Author(s): Stefania Basili, Valeria Raparelli, Marco Proietti, Laura Napoleone, Patrizia Ferroni and Flavia Franconi
Affiliation:
Keywords: Atrial fibrillation, anticoagulant therapy, gender differences, new oral anticoagulants.
Abstract: Atrial fibrillation (AF), one of the most prevalent supra-ventricular arrhythmia in adults, is related to a substantial increase in the risk of thromboembolic events requiring tailored preventive strategy. In AF, antithrombotic therapy should be individualized according to a careful decisionmaking process, taking in account the likely concomitant presence of risk factors for stroke and bleeding. Anticoagulation management is particularly challenging in women with AF, to the extent that female sex is incorporated in commonly used stratification schemes for both thromboembolic and bleeding risk evaluation. Nevertheless, gender- based differences on the efficacy and safety of either “old” (i.e. vitamin K antagonist) or “new” oral anticoagulants (i.e. direct thrombin inhibitors and activated factor X inhibitors) are not conclusive and not always reported. This review aims to analyse the literature on sex differences in AF anticoagulation management. We focus on safety data, bleeding complications and specific haemostatic mechanisms currently under investigation, which could account for observed disparities among sexes. Moreover, details on sex difference in response to anticoagulant treatment will be discussed. Comparing old and new antithrombotics, a need clearly emerges for differentiated and integrated strategies for the treatment of AF in female patients.
Export Options
About this article
Cite this article as:
Basili Stefania, Raparelli Valeria, Proietti Marco, Napoleone Laura, Ferroni Patrizia and Franconi Flavia, Old And New Oral Anticoagulants In Management Of Atrial Fibrillation: A Double-Edged Sword For Women, Current Vascular Pharmacology 2015; 13 (6) . https://dx.doi.org/10.2174/1570161113666150216152054
DOI https://dx.doi.org/10.2174/1570161113666150216152054 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Home Oxygen Therapy for the 21st Century
Current Respiratory Medicine Reviews Patents and Heart Valve Surgery - II: Tissue Valves
Recent Patents on Cardiovascular Drug Discovery Glucagon Like Peptide-1 and Atherosclerosis
Cardiovascular & Hematological Agents in Medicinal Chemistry Silicon Based Materials for Drug Delivery Devices and Implants
Recent Patents on Nanotechnology Dexmedetomidine: A Review of its Use for the Management of Pain, Agitation, and Delirium in the Intensive Care Unit
Current Pharmaceutical Design Myocardial Structure and Matrix Metalloproteinases
Current Topics in Medicinal Chemistry Coronary Artery Bypass Graft in HIV-Infected Patients: A Multicenter Case Control Study
Current HIV Research Clinical Utility of Biomarkers in Premature Atherosclerosis
Current Medicinal Chemistry Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf
Current Vascular Pharmacology TGFb and its Smad Connection to Cancer
Current Genomics The Role of Transforming Growth Factor β1 in the Regulation of Blood Pressure
Current Hypertension Reviews Managing Comorbidity in COPD: A Difficult Task
Current Drug Targets The Application of NMR Spectroscopy for the Study of Heart Failure
Current Pharmaceutical Design Cardioprotective Effects of Sour Cherry Seed Extract (SCSE) on the Hypercholesterolemic Rabbit Heart
Current Pharmaceutical Design HDL Genetic Defects
Current Pharmaceutical Design Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies
Reviews on Recent Clinical Trials Thyroid Disorders in Chronic Heart Failure: From Prognostic Set-up to Therapeutic Management
Endocrine, Metabolic & Immune Disorders - Drug Targets Biomarkers Associated with Atrial Fibrosis and Remodeling
Current Medicinal Chemistry Treatment of Pulmonary Thromboembolism in Patients with Systemic Blood Pressure Stability and Right Ventricular Dysfunction
Current Respiratory Medicine Reviews The Proteasome in Health and Disease
Current Pharmaceutical Design