John D. Chovan, James R. Cacchillo
Cardiac Arrhythmia, Coagulation Cascade
Cardiovascular Diseases | Medical Pathology | Medicine and Health Sciences | Nursing
Atrial fibrillation (afib) is the most common sustained cardiac arrhythmia and second most common cardiovascular condition in adults in the United States (Zarraga & Kron, 2012). •2.2 million affected, increases risk of stroke 4 to 6 times (National Institute of Neurological Disorders and Stroke [NINDS], 2015). •Vitamin K antagonists (VKAs) have been mainstay of therapy for over 60 years (King, Holley& Moores, 2013). •Limitations with VKAs such as variability in response, need for frequent lab draws, food and drug interactions which decrease patients adherence and under prescribing by physicians (Halperin & Goyette, 2012). •Novel oral anticoagulants (NOACs) have been approved by FDA over last 5 years for management of non-valvular afib and stroke prevention. •Non-valvular afib is afib in the absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair (Koza, 2014). •NOACs are direct thrombin inhibitors and Xa inhibitors that intend to improve patient adherence, simplify anticoagulation, and overcome barriers to long term therapy. •Important to know what population is appropriate, what are bleeding risks, reversal agents, cost, overall benefit to NOACs versus VKAs.
Viglietta, Kathryn A., "Non-Valvular Atrial Fibrillation and Stroke: Novel Oral Anticoagulants versus Vitamin K Antagonists" (2015). Master of Science in Nursing (MSN) Student Scholarship. Paper 91.