Abstract
Anticoagulant treatment can be currently instituted with two different classes of
drugs: the vitamin K antagonists (VKAs) and the newer, “novel” or non–vitamin K antagonist
oral anticoagulant drugs (NOACs). The NOACs have several practical advantages over
VKAs, such as the rapid onset/offset of action, the lower potential for food and drug
interactions, and the predictable anticoagulant response. However, the VKAs currently
have a broader spectrum of indications, a standardized monitoring test, and established
reversal strategies. The NOACs emerged as alternative options for the prevention and
treatment of venous thromboembolism and for the prevention of stroke and systemic
embolism in patients with nonvalvular atrial fibrillation. Nevertheless, there remain
some populations for whom the VKAs remain the most appropriate anticoagulant drug.
This article discusses the advantages and disadvantages of VKAs and NOACs.
Keywords
vitamin K antagonist - direct thrombin inhibitor - direct factor Xa inhibitor