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The place of warfarin in the era of direct oral anticoagulants: is an old friend better than two new ones?

Authors: Safiullina Z.M.1, Mezhonov E.M.1 2, Vyalkina Yu.A.1, Sereshcheva A.Kh.2

Company: 1 Tyumen State Medical University, Tyumen, Russian Federation
2 Regional Clinical Hospital # 1, Tyumen, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997- 3187-2024-18-2-145-152

For citation: Safiullina Z.M., Mezhonov E.M., Vyalkina Yu.A., Sereshcheva A.Kh. The place of warfarin in the era of direct oral anticoagulants: is an old friend better than two new ones? Creative Cardiology. 2024; 18 (2): 145–152 (in Russ.). DOI: 10.24022/1997- 3187-2024-18-2-145-152

Received / Accepted:  13.03.2024 / 30.05.2024

Keywords: warfarin vitamin K antagonist atrial fibrillation mechanical and biological artificial heart valves antiphospholipid syndrome left ventricular trombus terminal chronic kidney disease



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Abstract

The review discusses clinical situations and provides evidence-based medicine data with priority positions of vitamin K antagonists in the era of widespread use of direct oral anticoagulants. A number of authors consider direct oral anticoagulants as a reasonable alternative to vitamin K antagonists in patients with left ventricular thrombosis. This tactic may be especially attractive for patients who find it difficult to consistently reach the therapeutic range of international normalized relations (INR) or who have difficulty having frequent INR checks. Warfarin remains the drug of choice in the presence of mechanical prosthetic heart valves, atrial fibrillation in patients with moderate to severe mitral stenosis, antiphospholipid syndrome, in the presence of atrial fibrillation and end-stage chronic kidney disease (creatinine clearance less than 15 ml/min, hemodialysis).

References

  1. Arakelyan M.G., Bockeria L.A., Vasilieva E.Yu., Golitsyn S.P., Golukhova E.Z., Gorev M.V. et al. 2020 Clinical guidelines for atrial fibrillation and atrial flutter. Russian Journal of Cardiology. 2021; 26 (7): 4594 (in Russ.). DOI: 10.15829/1560-4071-2021-4594
  2. Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., Blomström-Lundqvist C. et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur. Heart J. 2020; 42 (5): 373–498. DOI: 10.1093/eurheartj/ehaa612
  3. Konstantinides S.V., Meyer G., Becattini C., Bueno H., Geersing G.J., Harjola V.P. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2020; 41 (4): 543–603. DOI: 10.1093/eurheartj/ehz405 Wan Y., Heneghan C., Perera R., Roberts N., Hollowell J., Glasziou P. et al. Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review. Circ. Cardiovasc. Qual. Outcomes. 2008; 1 (2): 84–91. DOI: 10.1161/CIRCOUTCOMES.108.796185
  4. Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann. Intern. Med. 2007; 146: 857–867. DOI: 10.7326/0003-4819-146-12-200706190-00007 Connolly S.J., Karthikeyan G., Ntsekhe M., Haileamlak A., El Sayed A., El Ghamrawy A. et al. Rivaroxaban in rheumatic heart disease-associated atrial fibrillation. N. Engl. J. Med. 2022; 87 (11): 978–988. DOI: 10.1056/NEJMoa2209051
  5. Ordi-Ros J., Sáez-Comet L., Pérez-Conesa M., Vidal X., Riera-Mestre A., Castro-Salomó A. et al. Rivaroxaban versus vitamin k antagonist in antiphospholipid syndrome: a randomized noninferiority trial. Ann. Intern. Med. 2019; 171 (10): 685–694. DOI: 10.7326/M19-0291
  6. Eikelboom J.W., Connoly S.J., Brueckmann M., Granger C.B., Kappetein A.P., Mack M.J. et al. Dabigatran versus warfarin in patients with mechanical heart valves. N. Engl. J. Med. 2013; 369: 1206–1214. DOI: 10.1111/jth.12500
  7. Pengo V., Denas G., Zoppellaro G., Jose S.P., Hoxha A., Ruffatti A. et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018; 132 (13): 1365–1371. DOI: 10.1182/blood-2018-04-848333
  8. Grigioni F., Avierinos J.-F., Ling L.H., Scott C.G., Bailey K.R., Tajik A.J. et al. Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome. J. Am. Coll. Cardiol. 2002; 40: 84–92. DOI: 10.1016/s0735-1097(02)01922-8
  9. Turpie A.G., Gunstensen J., Hirsh J., Nelson H., Gent M. Randomised comparison of two intensities of oral anticoagulant therapy after tissue heart valve replacement. Lancet. 1988; 1 (8597): 1242–1245. DOI: 10.1016/s0140-6736(88)92070-3
  10. Guimaraes H.P., Lopes R.D., de Barros E., Silva P.G.M., Liporace I.L., Sampaio R.O. et al. Rivaroxaban in patients with atrial fibrillation and a bioprosthetic mitral valve. N. Engl. J. Med. 2020; 383 (22): 2117–2126. DOI: 10.1056/NEJMoa2029603
  11. Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J. et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur. Heart J. 2022; 43 (7): 561–632. DOI: 10.1093/eurheartj/ehab395
  12. Otto C.M., Nishimura R.A., Bonow R.O., Carabello B.A., Erwin J.P., 3rd, Gentile F. et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J. Am. Coll. Cardiol. 2021; 77 (4): e25–e197. DOI: 10.1016/j.jacc.2020.11.018
  13. Ibanez B., James S., Agewall S., Antunes M.J., Bucciarelli-Ducci C., Bueno H. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2018; 39 (2): 119–177. DOI: 10.1093/eurheartj/ehx393
  14. Habash F., Vallurupalli S. Challenges in management of left ventricular thrombus. Ther. Adv. Cardiovasc. Dis. 2017; 11 (8): 203–213. DOI: 10.1177/1753944717711139
  15. Abdelnabi M., Saleh Y., Fareed A., Nossikof A., Wang L., Morsi M. et al. Comparative study of oral anticoagulation in left ventricular thrombi(No-LVT Trial). J. Am. Coll. Cardiol. 2021; 77 (12): 1590–1592. DOI: 10.1016/j.jacc.2021.01.049
  16. Alcalai R., Butnaru A., Moravsky G.,Yagel O., Rashad R., Ibrahimli M. et al. Apixaban versus warfarin in patients with left ventricular thrombus, a prospective multicenter randomized clinical trial. Eur. Heart J. Cardiovasc. Pharmacother. 2022; 8 (7): 660–667. DOI: 10.1093/ehjcvp/pvab057
  17. Isa W.Y.H.W., Hwong N., Yusof A.Kh.M., Yusof Z., Loong N.S., Nadiah W.-A., Naing N.N. et al. Apixaban versus warfarin in patients with left ventricular thrombus: a pilot prospective randomized outcome blinded study investigating size reduction or resolution of left ventricular thrombus. J. Clin. Prev. Cardiol. 2020; 9 (4): 150–154. DOI: 10.4103/jcpc.jcpc_41_20
  18. Levine G.N., McEvoy J.W., Fang J.C., Ibeh C., McCarthy C.P., Misra A. et al. Management of Patients at risk for and with left ventricular thrombus: a scientific statement from the American Heart Association. Circulation. 2022; 146 (15): e205–e223. DOI: 10.1161/CIR.0000000000001092
  19. Wizemann V., Tong L., Satayathum S., Disney A., Akiba T., Fissell R.B. et al. Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy. Kidney Int. 2010; 77: 1098–1106. DOI: 10.1038/ki.2009.477
  20. Zimmerman D., Sood M.M., Rigatto C., Holden R.M., Hiremath S., Clase C.M. Systematic review and meta-analysis of incidence, prevalence and outcomes of atrial fibrillation in patients on dialysis. Nephrol. Dial. Transplant. 2012; 27: 3816– 3822. DOI: 10.1093/ndt/gfs416
  21. Kovesdy C.P. Epidemiology of chronic kidney disease: an update 2022. Kidney Int. Suppl. 2022; 12 (1): 7–11. DOI: 10.1016/j. kisu.2021.11.003
  22. Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., Blomström-Lundqvist C. et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur. Heart J. 2021; 42 (5): 373–498. DOI: 10.1093/eurheartj/ehaa612

About Authors

  • Zemfira M. Safiullina, Dr. Med. Sci., Professor of Chair; ORCID
  • Evgeniy M. Mezhonov, Dr. Med. Sci., Associate Professor, Professor of Chair of Cardiology and Cardiac Surgery with an Emergency Care Course at the Institute of Clinical Medicine of TSMU, Cardiologist of RCH # 1; ORCID
  • Yuliya A. Vyalkina, Cand. Med. Sci., Associate Professor of Chair; ORCID
  • Alevtina Kh. Sereshcheva, Cand. Med. Sci., Cardiologist, Head of Department; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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