Oral anticoagulants and atrial fibrillation: A South African perspective

This review evaluates the current literature on available oral anticoagulants and atrial fibrillation with specific relevance to the South African (SA) public healthcare sector, focusing on the pharmacology and monitoring of anticoagulants, current guidelines, initiation of treatment and risk strati...

Full description

Bibliographic Details
Main Authors: D Laäs, M Naidoo
Format: Article
Language:English
Published: South African Medical Association 2018-07-01
Series:South African Medical Journal
Online Access:http://www.samj.org.za/index.php/samj/article/download/12368/8560
_version_ 1797368155540029440
author D Laäs
M Naidoo
author_facet D Laäs
M Naidoo
author_sort D Laäs
collection DOAJ
description This review evaluates the current literature on available oral anticoagulants and atrial fibrillation with specific relevance to the South African (SA) public healthcare sector, focusing on the pharmacology and monitoring of anticoagulants, current guidelines, initiation of treatment and risk stratification, effectiveness of treatment, cost-effectiveness and specific costing implications. The direct-acting oral anticoagulants (DOACs) are superior to warfarin, with dabigatran being the preferred treatment option in patients with non-valvular atrial fibrillation (NVAF). Warfarin is still the preferred anticoagulant in patients with renal failure and prosthetic heart valves and is still the most cost-effective anticoagulant in the SA public sector setting. There is a growing body of evidence that demonstrates the advantages of DOACs over warfarin in NVAF. Warfarin will remain the anticoagulant of choice until cheaper generic DOACs become available.
first_indexed 2024-03-08T17:28:32Z
format Article
id doaj.art-46e140f5c9474141880d88120a8d0a20
institution Directory Open Access Journal
issn 0256-9574
2078-5135
language English
last_indexed 2024-03-08T17:28:32Z
publishDate 2018-07-01
publisher South African Medical Association
record_format Article
series South African Medical Journal
spelling doaj.art-46e140f5c9474141880d88120a8d0a202024-01-02T16:50:55ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352018-07-01108864064610.7196/SAMJ.2018.v108i8.13309Oral anticoagulants and atrial fibrillation: A South African perspectiveD LaäsM NaidooThis review evaluates the current literature on available oral anticoagulants and atrial fibrillation with specific relevance to the South African (SA) public healthcare sector, focusing on the pharmacology and monitoring of anticoagulants, current guidelines, initiation of treatment and risk stratification, effectiveness of treatment, cost-effectiveness and specific costing implications. The direct-acting oral anticoagulants (DOACs) are superior to warfarin, with dabigatran being the preferred treatment option in patients with non-valvular atrial fibrillation (NVAF). Warfarin is still the preferred anticoagulant in patients with renal failure and prosthetic heart valves and is still the most cost-effective anticoagulant in the SA public sector setting. There is a growing body of evidence that demonstrates the advantages of DOACs over warfarin in NVAF. Warfarin will remain the anticoagulant of choice until cheaper generic DOACs become available.http://www.samj.org.za/index.php/samj/article/download/12368/8560
spellingShingle D Laäs
M Naidoo
Oral anticoagulants and atrial fibrillation: A South African perspective
South African Medical Journal
title Oral anticoagulants and atrial fibrillation: A South African perspective
title_full Oral anticoagulants and atrial fibrillation: A South African perspective
title_fullStr Oral anticoagulants and atrial fibrillation: A South African perspective
title_full_unstemmed Oral anticoagulants and atrial fibrillation: A South African perspective
title_short Oral anticoagulants and atrial fibrillation: A South African perspective
title_sort oral anticoagulants and atrial fibrillation a south african perspective
url http://www.samj.org.za/index.php/samj/article/download/12368/8560
work_keys_str_mv AT dlaas oralanticoagulantsandatrialfibrillationasouthafricanperspective
AT mnaidoo oralanticoagulantsandatrialfibrillationasouthafricanperspective