Abstract
Anticoagulant therapy plays an important role in thromboembolic disorders, in primary and secondary prevention as well as treatment, and especially in the prevention of brain systemic embolism in patients with non-valvular atrial fibrillation and other sources of cardioembolic strokes. Unless contraindicated, warfarin is recommended for the treatment of these patients.
Warfarin significantly reduces the risks of stroke and death, but increases that of haemorrhage. Life-threatening intracerebral haemorrhage is the most serious complication of oral anticoagulant therapy, with a mortality that can exceed 50%.
The need for frequent laboratory monitoring, a narrow therapeutic window, and a plethora of interactions with food and drugs are also reasons to seek new, safe, effective anticoagulant agents that are convenient to use. New oral direct thrombin inhibitors and factor Xa inhibitors present promising alternatives to warfarin.