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Aktuelle Kardiologie 2012; 1(3): 192-198
DOI: 10.1055/s-0032-1315031
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Antikoagulantion bei Vorhofflimmern: Neue Substanzen – für wen (nicht)?

Anticoagulation for Atrial Fibrillation: New Oral Anticoagulants?
H. Omran
1   Innere Abteilung des St. Marien Hospitals Bonn Venusberg und Innere Medizin II des St. Josef Hospital Bonn Beuel
,
G. von der Recke
1   Innere Abteilung des St. Marien Hospitals Bonn Venusberg und Innere Medizin II des St. Josef Hospital Bonn Beuel
› Author Affiliations
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Publication History

Publication Date:
15 August 2012 (online)

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Zusammenfassung

Mit Dabigatran und Rivaroxaban stehen derzeit 2 zugelassene neue orale Antikoagulanzien zur Therapie von Vorhofflimmern zur Verfügung, und die Zulassung von Apixaban ist absehbar. Alle Substanzen haben ein günstigeres pharmakologisches Profil als Vitamin-K-Antagonisten, bedürfen in der Regel keiner laborchemischen Überwachung und sind sicherer. Insbesondere reduzieren die neuen oralen Antikoagulanzien die Rate intrakranieller Blutungen. Sowohl Dabigatran als auch Apixaban senken die Häufigkeit von Schlaganfällen signifikant. Dabigatran in einer Dosis von 2 × 150 mg senkt die Raten ischämischer Schlaganfälle, während Apixaban die Gesamtmortalität senkt. Rivaroxaban hat den Vorteil der Einmalgabe und kann bis zu einer CrCl von 15 ml/min gegeben werden.

Abstract

Dabigatran and rivaroxaban are 2 newly licensed oral anticoagulants for the treatment of atrial fibrillation. It is expected that apixaban will also soon be approved for clinical use. All of these substances have a more favorable pharmacological profile than vitamin K antagonists. They generally do not require routine laboratory monitoring and are safer. The new oral anticoagulants were found to reduce rates of intracranial bleeding. Both dabigatran and apixaban significantly reduced the incidence of stroke. Dabigatran administered at a dosage of 2 × 150 mg reduced the rates of ischemic stroke, while apixaban reduced overall mortality. Rivaroxaban has the advantage that it is administered as a single dose and can be administered up to a CrCl of 15 ml/min.

Schlüsselwörter

neue orale Antikoagulanzien - Vorhofflimmern - Apixaban - Dabigatran - Rivaroxaban

Key words

new oral anticoagulants - atrial fibrillation - Apixaban - Dabigatran - Rivaroxaban
 

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