Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Review Article

Direct Oral Anticoagulants use in Patients with Stable Coronary Artery Disease, Acute Coronary Syndrome or Undergoing Percutaneous Coronary Intervention

Author(s): Marios Sagris*, Panagiotis Theofilis, Angelos Papanikolaou, Alexios S. Antonopoulos, Constantinos Tsioufis and Dimitris Tousoulis

Volume 29, Issue 35, 2023

Published on: 30 November, 2023

Page: [2787 - 2794] Pages: 8

DOI: 10.2174/0113816128259508231118141831

Price: $65

Abstract

The investigation for the optimal anticoagulation strategy for patients with stable coronary artery disease, acute coronary syndromes, and undergoing percutaneous coronary intervention constitutes a great challenge for physicians and is a field of extensive research. Although aspirin is commonly recommended as a protective measure for all patients with coronary artery disease and dual antiplatelet therapy for those undergoing procedures, such as percutaneous coronary intervention or coronary artery bypass graft surgery, the risk of recurrent cardiovascular events remains significant. In this context, the shortcomings associated with the use of vitamin K antagonists have led to the assessment of direct oral anticoagulants as promising alternatives. This review will explore and provide a comprehensive analysis of the existing data regarding the use of direct oral anticoagulants in patients with stable coronary artery disease or acute coronary syndrome, as well as their effectiveness in those undergoing percutaneous coronary intervention or coronary artery bypass graft surgery.

[1]
Favaloro E, Sanchis-Gomar F, Lippi G. Sudden cardiac and noncardiac death in sports: Epidemiology, causes, pathogenesis, and prevention. Semin Thromb Hemost 2018; 44(8): 780-6.
[http://dx.doi.org/10.1055/s-0038-1661334] [PMID: 29864776]
[2]
Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Circulation 2011; 124(22): 2458-73.
[http://dx.doi.org/10.1161/CIR.0b013e318235eb4d] [PMID: 22052934]
[3]
Bell AD, Roussin A, Cartier R, et al. The use of antiplatelet therapy in the outpatient setting: Canadian cardiovascular society guidelines. Can J Cardiol 2011; 27: S1-59.
[4]
Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357(20): 2001-15.
[http://dx.doi.org/10.1056/NEJMoa0706482] [PMID: 17982182]
[5]
Posch F, Königsbrügge O, Zielinski C, Pabinger I, Ay C. Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants. Thromb Res 2015; 136(3): 582-9.
[http://dx.doi.org/10.1016/j.thromres.2015.07.011] [PMID: 26210891]
[6]
Jame S, Barnes G. Stroke and thromboembolism prevention in atrial fibrillation. Heart 2020; 106(1): 10-7.
[http://dx.doi.org/10.1136/heartjnl-2019-314898] [PMID: 31533990]
[7]
Karcioglu O, Zengin S, Ozkaya B, et al. Direct (New) Oral Anticoagulants (DOACs): Drawbacks, bleeding and reversal. Cardiovasc Hematol Agents Med Chem 2022; 20(2): 103-13.
[http://dx.doi.org/10.2174/1871525719666210914110750] [PMID: 34521332]
[8]
López-López JA, Sterne JAC, Thom HHZ, et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: Systematic review, network meta-analysis, and cost effectiveness analysis. BMJ 2017; 359: j5058.
[http://dx.doi.org/10.1136/bmj.j5058] [PMID: 29183961]
[9]
Theofilis P, Sagris M, Antonopoulos AS, Oikonomou E, Tsioufis K, Tousoulis D. Non-invasive modalities in the assessment of vulnerable coronary atherosclerotic plaques. Tomography 2022; 8(4): 1742-58.
[http://dx.doi.org/10.3390/tomography8040147] [PMID: 35894012]
[10]
Peppas S, Sagris Μ, Bikakis I, et al. A systematic review and meta-analysis on the efficacy and safety of direct oral anticoagulants in patients with peripheral artery disease. Ann Vasc Surg 2022; 80: 1-11.
[http://dx.doi.org/10.1016/j.avsg.2021.07.028] [PMID: 34644644]
[11]
Ansell J. New anticoagulants and their potential impact on the treatment of thromboembolic disease. Curr Hematol Rep 2004; 3(5): 357-62.
[PMID: 15341703]
[12]
Ktenopoulos N, Sagris M, Theofilis P, Lionaki S, Rallidis LS. Direct oral anticoagulants in patients on chronic dialysis and concomitant atrial fibrillation: A common clinical impasse. Front Biosci (Schol Ed) 2022; 14(3): 21.
[http://dx.doi.org/10.31083/j.fbs1403021] [PMID: 36137976]
[13]
Camire RM. Blood coagulation factor X: Molecular biology, inherited disease, and engineered therapeutics. J Thromb Thrombolysis 2021; 52(2): 383-90.
[http://dx.doi.org/10.1007/s11239-021-02456-w] [PMID: 33886037]
[14]
Harder S, Graff J. Novel oral anticoagulants: Clinical pharmacology, indications and practical considerations. Eur J Clin Pharmacol 2013; 69(9): 1617-33.
[http://dx.doi.org/10.1007/s00228-013-1510-z] [PMID: 23619611]
[15]
Sindet-Pedersen C, Pallisgaard JL, Staerk L, et al. Temporal trends in initiation of VKA, rivaroxaban, apixaban and dabigatran for the treatment of venous thromboembolism - A Danish nationwide cohort study. Sci Rep 2017; 7(1): 3347.
[http://dx.doi.org/10.1038/s41598-017-03596-x] [PMID: 28611403]
[16]
Renner E, Barnes GD. Antithrombotic management of venous thromboembolism. J Am Coll Cardiol 2020; 76(18): 2142-54.
[http://dx.doi.org/10.1016/j.jacc.2020.07.070] [PMID: 33121722]
[17]
Kopytek M, Zabczyk M, Natorska J, Malinowski KP, Undas A. Effects of direct oral anticoagulants on thromboelastographic parameters and fibrin clot properties in patients with venous thromboembolism. J Physiol Pharmacol 2020; 71(1): 47-53.
[PMID: 32350148]
[18]
Oikonomou E, Tsaplaris P, Anastasiou A, et al. Interleukin-1 in coronary artery disease. Curr Top Med Chem 2022; 22(28): 2368-89.
[http://dx.doi.org/10.2174/1568026623666221017144734] [PMID: 36263481]
[19]
Pokorney SD, Holmes DN, Thomas L, et al. Association between warfarin control metrics and atrial fibrillation outcomes in the outcomes registry for better informed treatment of atrial fibrillation. JAMA Cardiol 2019; 4(8): 756-64.
[http://dx.doi.org/10.1001/jamacardio.2019.1960] [PMID: 31268487]
[20]
Chan NC, Bhagirath V, Eikelboom JW. Profile of betrixaban and its potential in the prevention and treatment of venous thromboembolism. Vasc Health Risk Manag 2015; 11: 343-51.
[PMID: 26170684]
[21]
Cohen AT, Harrington RA, Goldhaber SZ, et al. Extended thromboprophylaxis with betrixaban in acutely Ill medical patients. N Engl J Med 2016; 375(6): 534-44.
[http://dx.doi.org/10.1056/NEJMoa1601747] [PMID: 27232649]
[22]
Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol 2018; 72(18): 2231-64.
[http://dx.doi.org/10.1016/j.jacc.2018.08.1038] [PMID: 30153967]
[23]
Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). Circulation 2018; 138(20): e618-51.
[http://dx.doi.org/10.1161/CIR.0000000000000617] [PMID: 30571511]
[24]
Turgeon RD, Ackman ML, Babadagli HE, et al. The role of direct oral anticoagulants in patients with coronary artery disease. J Cardiovasc Pharmacol Ther 2019; 24(2): 103-12.
[http://dx.doi.org/10.1177/1074248418795889] [PMID: 30122072]
[25]
Anand SS, Yusuf S. Oral anticoagulants in patients with coronary artery disease. J Am Coll Cardiol 2003; 41(4): S62-9.
[http://dx.doi.org/10.1016/S0735-1097(02)02776-6] [PMID: 12644343]
[26]
Bauer KA. Pros and cons of new oral anticoagulants. Hematology (Am Soc Hematol Educ Program) 2013; 2013(1): 464-70.
[http://dx.doi.org/10.1182/asheducation-2013.1.464] [PMID: 24319220]
[27]
Sagris M, Kokkinidis DG, Lempesis IG, et al. Nutrition, dietary habits, and weight management to prevent and treat patients with peripheral artery disease. Rev Cardiovasc Med 2020; 21(4): 565-75.
[http://dx.doi.org/10.31083/j.rcm.2020.04.202] [PMID: 33388001]
[28]
Sagris M, Theofilis P, Antonopoulos AS, Oikonomou E, Tsioufis K, Tousoulis D. Genetic predisposition and inflammatory inhibitors in COVID-19: Where do we stand? Biomedicines 2022; 10(2): 242.
[http://dx.doi.org/10.3390/biomedicines10020242] [PMID: 35203452]
[29]
Chopard R, Albertsen IE, Piazza G. Diagnosis and treatment of lower extremity venous thromboembolism. JAMA 2020; 324(17): 1765-76.
[http://dx.doi.org/10.1001/jama.2020.17272] [PMID: 33141212]
[30]
Diavati S, Sagris M, Terentes-Printzios D, Vlachopoulos C. Anticoagulation treatment in venous thromboembolism: Options and optimal duration. Curr Pharm Des 2022; 28(4): 296-305.
[http://dx.doi.org/10.2174/1381612827666211111150705] [PMID: 34766887]
[31]
Aboyans V, Ricco JB, Bartelink MLEL, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J 2018; 39(9): 763-816.
[http://dx.doi.org/10.1093/eurheartj/ehx095] [PMID: 28886620]
[32]
Sagris M, Giannopoulos S, Giannopoulos S, et al. Transcervical carotid artery revascularization: A systematic review and meta-analysis of outcomes. J Vasc Surg 2021; 74(2): 657-665.e12.
[http://dx.doi.org/10.1016/j.jvs.2021.03.032] [PMID: 33864829]
[33]
Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 2017; 377(14): 1319-30.
[http://dx.doi.org/10.1056/NEJMoa1709118] [PMID: 28844192]
[34]
Steffel J, Eikelboom JW, Anand SS, Shestakovska O, Yusuf S, Fox KAA. The COMPASS trial. Circulation 2020; 142(1): 40-8.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.120.046048] [PMID: 32436455]
[35]
Anand SS, Bosch J, Eikelboom JW, et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: An international, randomised, double-blind, placebo-controlled trial. Lancet 2018; 391(10117): 219-29.
[http://dx.doi.org/10.1016/S0140-6736(17)32409-1] [PMID: 29132880]
[36]
Kaplovitch E, Eikelboom JW, Dyal L, et al. Rivaroxaban and aspirin in patients with symptomatic lower extremity peripheral artery disease: A subanalysis of the COMPASS randomized clinical trial. JAMA Cardiol 2021; 6(1): 21-9.
[PMID: 32997098]
[37]
Yasuda S, Kaikita K, Akao M, et al. Antithrombotic therapy for atrial fibrillation with stable coronary disease. N Engl J Med 2019; 381(12): 1103-13.
[http://dx.doi.org/10.1056/NEJMoa1904143] [PMID: 31475793]
[38]
Kumbhani DJ, Cannon CP, Beavers CJ, et al. 2020 ACC expert consensus decision pathway for anticoagulant and antiplatelet therapy in patients with atrial fibrillation or venous thromboembolism undergoing percutaneous coronary intervention or with atherosclerotic cardiovascular disease. J Am Coll Cardiol 2021; 77(5): 629-58.
[http://dx.doi.org/10.1016/j.jacc.2020.09.011] [PMID: 33250267]
[39]
Ma F, Yuan L, Wen X, Wang Y, Li Q, Chen C. Efficacy and safety of direct oral anticoagulants in stable coronary artery disease and atrial fibrillation: A systematic review and network meta-analysis. Clin Appl Thromb Hemost 2022; 28: 10760296221131033.
[http://dx.doi.org/10.1177/10760296221131033] [PMID: 36198012]
[40]
Sagris M, Antonopoulos AS, Simantiris S, et al. Pericoronary fat attenuation index-a new imaging biomarker and its diagnostic and prognostic utility: A systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging 2022; 23(12): e526-36.
[http://dx.doi.org/10.1093/ehjci/jeac174] [PMID: 36069510]
[41]
Alexander JH, Becker RC, Bhatt DL, et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: Results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009; 119(22): 2877-85.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.832139] [PMID: 19470889]
[42]
Alexander JH, Lopes RD, James S, et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med 2011; 365(8): 699-708.
[http://dx.doi.org/10.1056/NEJMoa1105819] [PMID: 21780946]
[43]
Oldgren J, Budaj A, Granger CB, et al. Dabigatran vs. placebo in patients with acute coronary syndromes on dual antiplatelet therapy: A randomized, double-blind, phase II trial. Eur Heart J 2011; 32(22): 2781-9.
[http://dx.doi.org/10.1093/eurheartj/ehr113] [PMID: 21551462]
[44]
Mega JL, Braunwald E, Wiviott SD, et al. Rivaroxaban in patients with a recent acute coronary syndrome. N Engl J Med 2012; 366(1): 9-19.
[http://dx.doi.org/10.1056/NEJMoa1112277] [PMID: 22077192]
[45]
Ohman EM, Roe MT, Steg PG, et al. Clinically significant bleeding with low-dose rivaroxaban versus aspirin, in addition to P2Y12 inhibition, in acute coronary syndromes (GEMINI-ACS-1): A double-blind, multicentre, randomised trial. Lancet 2017; 389(10081): 1799-808.
[http://dx.doi.org/10.1016/S0140-6736(17)30751-1] [PMID: 28325638]
[46]
Steg PG, Mehta SR, Pollack CV Jr, et al. Anticoagulation with otamixaban and ischemic events in non-ST-segment elevation acute coronary syndromes: The TAO randomized clinical trial. JAMA 2013; 310(11): 1145-55.
[http://dx.doi.org/10.1001/jama.2013.277165] [PMID: 23995608]
[47]
Steg PG, Mehta SR, Jukema JW, et al. RUBY-1: A randomized, double-blind, placebo-controlled trial of the safety and tolerability of the novel oral factor Xa inhibitor darexaban (YM150) following acute coronary syndrome. Eur Heart J 2011; 32(20): 2541-54.
[http://dx.doi.org/10.1093/eurheartj/ehr334] [PMID: 21878434]
[48]
Vranckx P, Verheugt FWA, de Maat MP, et al. A randomised study of dabigatran in elective percutaneous coronary intervention in stable coronary artery disease patients. EuroIntervention 2013; 8(9): 1052-60.
[http://dx.doi.org/10.4244/EIJV8I9A162] [PMID: 23182947]
[49]
Vranckx P, Leebeek F, Tijssen J, et al. Peri-procedural use of rivaroxaban in elective percutaneous coronary intervention to treat stable coronary artery disease. Thromb Haemost 2015; 114(8): 258-67.
[http://dx.doi.org/10.1160/TH15-01-0061] [PMID: 25925992]
[50]
Lamy A, Eikelboom J, Sheth T, et al. Rivaroxaban, aspirin, or both to prevent early coronary bypass graft occlusion. J Am Coll Cardiol 2019; 73(2): 121-30.
[http://dx.doi.org/10.1016/j.jacc.2018.10.048] [PMID: 30654882]
[51]
Goto S, Bhatt DL, Rother J, et al. Prevalence, clinical profile, and cardiovascular outcomes of atrial fibrillation patients with atherothrombosis. Am Heart J 2008; 156(5): 855-63.
[http://dx.doi.org/10.1016/j.ahj.2008.06.029]
[52]
Connolly S, Pogue J, Hart R, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): A randomised controlled trial. Lancet 2006; 367(9526): 1903-12.
[http://dx.doi.org/10.1016/S0140-6736(06)68845-4] [PMID: 16765759]
[53]
Rubboli A, Milandri M, Castelvetri C, Cosmi B. Meta-analysis of trials comparing oral anticoagulation and aspirin versus dual antiplatelet therapy after coronary stenting. Clues for the management of patients with an indication for long-term anticoagulation undergoing coronary stenting. Cardiology 2005; 104(2): 101-6.
[http://dx.doi.org/10.1159/000086918] [PMID: 16020950]
[54]
Hess CN, Peterson ED, Peng SA, et al. Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation. J Am Coll Cardiol 2015; 66(6): 616-27.
[http://dx.doi.org/10.1016/j.jacc.2015.05.062] [PMID: 26248987]
[55]
Gibson CM, Mehran R, Bode C, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med 2016; 375(25): 2423-34.
[http://dx.doi.org/10.1056/NEJMoa1611594] [PMID: 27959713]
[56]
Cannon CP, Bhatt DL, Oldgren J, et al. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N Engl J Med 2017; 377(16): 1513-24.
[http://dx.doi.org/10.1056/NEJMoa1708454] [PMID: 28844193]
[57]
Lopes RD, Heizer G, Aronson R, et al. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med 2019; 380(16): 1509-24.
[http://dx.doi.org/10.1056/NEJMoa1817083] [PMID: 30883055]
[58]
Vranckx P, Valgimigli M, Eckardt L, et al. Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI): A randomised, open-label, phase 3b trial. Lancet 2019; 394(10206): 1335-43.
[http://dx.doi.org/10.1016/S0140-6736(19)31872-0] [PMID: 31492505]
[59]
Capodanno D, Huber K, Mehran R, et al. Management of antithrombotic therapy in atrial fibrillation patients undergoing PCI. J Am Coll Cardiol 2019; 74(1): 83-99.
[http://dx.doi.org/10.1016/j.jacc.2019.05.016] [PMID: 31272556]
[60]
Choxi R, Kapoor K, Mackman N, Jovin IS. Direct oral anticoagulants and coronary artery disease. Arterioscler Thromb Vasc Biol 2022; 42(5): 553-64.
[http://dx.doi.org/10.1161/ATVBAHA.121.317171] [PMID: 35296151]
[61]
Yamashita Y, Morimoto T, Kimura T. Venous thromboembolism: Recent advancement and future perspective. J Cardiol 2022; 79(1): 79-89.
[http://dx.doi.org/10.1016/j.jjcc.2021.08.026] [PMID: 34518074]
[62]
Ryu R, Tran R. DOACs in mechanical and bioprosthetic heart valves: A narrative review of emerging data and future directions. Clin Appl Thromb Hemost 2022; 28
[http://dx.doi.org/10.1177/10760296221103578] [PMID: 35642259]
[63]
Kanuri SH, Kreutz RP. Pharmacogenomics of novel direct oral anticoagulants: Newly identified genes and genetic variants. J Pers Med 2019; 9(1): 7.
[http://dx.doi.org/10.3390/jpm9010007] [PMID: 30658513]
[64]
Sagris M, Theofilis P, Antonopoulos AS, Tsioufis K, Tousoulis D. Telomere length: A cardiovascular biomarker and a novel therapeutic target. Int J Mol Sci 2022; 23(24): 16010.
[http://dx.doi.org/10.3390/ijms232416010] [PMID: 36555658]
[65]
Cullell N, Carrera C, Muiño E, Torres N, Krupinski J, Fernandez- Cadenas I. Pharmacogenetic studies with oral anticoagulants. Genome-wide association studies in vitamin K antagonist and direct oral anticoagulants. Oncotarget 2018; 9(49): 29238-58.
[http://dx.doi.org/10.18632/oncotarget.25579] [PMID: 30018749]
[66]
Renné T, Pozgajová M, Grüner S, et al. Defective thrombus formation in mice lacking coagulation factor XII. J Exp Med 2005; 202(2): 271-81.
[http://dx.doi.org/10.1084/jem.20050664] [PMID: 16009717]
[67]
Weitz JI. Factor XI and factor XII as targets for new anticoagulants. Thromb Res 2016; 141(Suppl. 2): S40-5.
[http://dx.doi.org/10.1016/S0049-3848(16)30363-2] [PMID: 27207423]
[68]
Verhamme P, Yi BA, Segers A, et al. Abelacimab for prevention of venous thromboembolism. N Engl J Med 2021; 385(7): 609-17.
[http://dx.doi.org/10.1056/NEJMoa2105872] [PMID: 34297496]
[69]
Büller HR, Bethune C, Bhanot S, et al. Factor XI antisense oligonucleotide for prevention of venous thrombosis. N Engl J Med 2015; 372(3): 232-40.
[http://dx.doi.org/10.1056/NEJMoa1405760] [PMID: 25482425]
[70]
Weitz JI, Strony J, Ageno W, et al. Milvexian for the prevention of venous thromboembolism. N Engl J Med 2021; 385(23): 2161-72.
[http://dx.doi.org/10.1056/NEJMoa2113194] [PMID: 34780683]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy