AVALIAÇÃO DA EFICÁCIA DAS NOVAS TERAPIAS ANTICOAGULANTES ORAIS NA PREVENÇÃO DE EVENTOS RELACIONADOS À FIBRILAÇÃO ATRIAL: UMA REVISÃO BIBLIOGRÁFICA
DOI:
https://doi.org/10.47820/recima21.v5i5.5203Palavras-chave:
Fibrilação Atrial, Novas Terapias Anticoagulantes Orais, Prevenção de Eventos CardiovascularesResumo
A fibrilação atrial é uma condição clínica comum associada a um aumento significativo no risco de eventos cardiovasculares, como o acidente vascular cerebral (AVC). O advento das novas terapias anticoagulantes orais, como os inibidores diretos do fator Xa e da trombina, trouxe novas perspectivas para o tratamento e prevenção desses eventos. Objetivo: Esta revisão bibliográfica tem como objetivo avaliar a eficácia das novas terapias anticoagulantes orais na prevenção de eventos cardiovasculares relacionados à fibrilação atrial. Métodos: Esta revisão bibliográfica foi conduzida por meio de uma busca sistemática na literatura científica publicada nos últimos 15 anos, abrangendo o período de 2009 a 2024, utilizando as bases de dados PubMed, Web of Science, Scopus e Google Scholar. Foram incluídos estudos originais e revisões que investigaram as características das novas terapias anticoagulantes orais e sua eficácia na prevenção de eventos cardiovasculares em pacientes com fibrilação atrial. Resultados e Discussão: Os estudos revisados destacaram a eficácia das novas terapias anticoagulantes orais na redução do risco de eventos cardiovasculares, como o AVC, em comparação com a varfarina. Além disso, esses medicamentos mostraram um perfil de segurança favorável, com menor incidência de sangramento intracraniano. A adesão e conformidade ao tratamento também foram ressaltadas como vantagens das novas terapias, contribuindo para uma melhor qualidade de vida dos pacientes. Conclusão: A revisão evidenciou a importância das novas terapias anticoagulantes orais na prática clínica, fornecendo uma análise abrangente e atualizada sobre sua eficácia, segurança e impacto econômico.
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Referências
AMIN, Alpesh et al. Estimation of the impact of warfarin’s time-in-therapeutic range on stroke and major bleeding rates and its influence on the medical cost avoidance associated with novel oral anticoagulant use-learnings from ARISTOTLE, ROCKET-AF, and RE-LY trials. Journal of thrombosis and thrombolysis, v. 38, p. 150-159, 2014. DOI: https://doi.org/10.1007/s11239-013-1048-z
BANG, Oh Young et al. The risk of stroke/systemic embolism and major bleeding in Asian patients with non-valvular atrial fibrillation treated with non-vitamin K oral anticoagulants compared to warfarin: Results from a real-world data analysis. PLoS One, v. 15, n. 11, p. e0242922, 2020. DOI: https://doi.org/10.1371/journal.pone.0242922
CARDOSO, Rhanderson et al. Non-vitamin K antagonists versus warfarin in patients with atrial fibrillation and bioprosthetic valves: a systematic review and meta-analysis. The American Journal of Medicine, v. 135, n. 2, p. 228-234, e1, 2022. DOI: https://doi.org/10.1016/j.amjmed.2021.08.026
CINTRA, Fatima Dumas; FIGUEIREDO, Marcio Jansen de Oliveira. Fibrilação atrial (Parte 1): fisiopatologia, fatores de risco e bases terapêuticas. Arquivos Brasileiros de Cardiologia, v. 116, p. 129-139, 2021. DOI: https://doi.org/10.36660/abc.20200485
COSTELLO, M. et al. Effect of non‐vitamin‐K oral anticoagulants on stroke severity compared to warfarin: a meta‐analysis of randomized controlled trials. European journal of neurology, v. 27, n. 3, p. 413-418, 2020. DOI: https://doi.org/10.1111/ene.14134
DALIA, Adam A. et al. Anesthesiologists guide to the 2019 AHA/ACC/HRS focused update for the management of patients with atrial fibrillation. Journal of cardiothoracic and vascular anesthesia, v. 34, n. 7, p. 1925-1932, 2020. DOI: https://doi.org/10.1053/j.jvca.2019.08.046
DEMARIA, Anthony; COTTER, Bruno. Choosing between a NOAC or a vitamin K antagonist: an approach based on risk stratification. European Heart Journal, v. 38, n. 12, p. 897-898, 2017. DOI: https://doi.org/10.1093/eurheartj/ehw644
GELLER, Bram J. et al. Systemic, noncerebral, arterial embolism in 21,105 patients with atrial fibrillation randomized to edoxaban or warfarin: results from the Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction Study 48 trial. American Heart Journal, v. 170, n. 4, p. 669-674, 2015. DOI: https://doi.org/10.1016/j.ahj.2015.06.020
HE, Qiyu et al. Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with valvular heart diseases: a meta-analysis. BMC Cardiovascular Disorders, v. 19, p. 1-13, 2019. DOI: https://doi.org/10.1186/s12872-019-1089-0
HEO, MuHyung et al. Comparison of Early Complications of Oral Anticoagulants after Totally Thoracoscopic Ablation: Warfarin versus Non-vitamin K Antagonist Oral Anticoagulants. Journal of Chest Surgery, v. 56, n. 2, p. 90, 2023. DOI: https://doi.org/10.5090/jcs.22.081
HU, Jingjing; ZHOU, Yidan; CAI, Zhaobin. Outcome of novel oral anticoagulant versus warfarin in frail elderly patients with atrial fibrillation: a systematic review and meta-analysis of retrospective studies. Acta Clinica Belgica, v. 78, n. 5, p. 367-377, 2023. DOI: https://doi.org/10.1080/17843286.2023.2179908
JANUARY, Craig T. et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation, v. 130, n. 23, p. 2071-2104, 2014. DOI: https://doi.org/10.1161/CIR.0000000000000040
JONES, Daniel A. et al. The use of novel oral anticoagulants compared to vitamin K antagonists (warfarin) in patients with left ventricular thrombus after acute myocardial infarction. European Heart Journal-Cardiovascular Pharmacotherapy, v. 7, n. 5, p. 398-404, 2021. DOI: https://doi.org/10.1093/ehjcvp/pvaa096
JUSTO, Fernanda Augusto; SILVA, Ana Flávia Garcia. Aspectos epidemiológicos da fibrilação atrial. Revista de Medicina, v. 93, n. 1, p. 1-13, 2014. DOI: https://doi.org/10.11606/issn.1679-9836.v93i1p1-13
KUMBHANI, Dharam J. et al. Caminho de decisão de consenso de especialistas do ACC 2020 para terapia anticoagulante e antiplaquetária em pacientes com fibrilação atrial ou tromboembolismo venoso submetidos a intervenção coronária percutânea ou com doença cardiovascular aterosclerótica: um relatório do Comitê de Supervisão do Conjunto de Soluções do American College of Cardiology. Jornal do Colégio Americano de Cardiologia, v. 77, n. 5, pág. 629-658, 2021.
KUNDU, Amartya et al. Minimizing the risk of bleeding with NOACs in the elderly. Drugs & aging, v. 33, p. 491-500, 2016. DOI: https://doi.org/10.1007/s40266-016-0376-z
LIMA, Paula Rocco Gomes et al. Fatores relacionados à adesão de pacientes ao uso de novos anticoagulantes orais. Revista da Escola de Enfermagem da USP, v. 56, p. e20210191, 2021. DOI: https://doi.org/10.5935/978-65-5848-242-0.C0005
LIP, Gregory Y. H. et al. Effectiveness and safety of oral anticoagulants among nonvalvular atrial fibrillation patients: the ARISTOPHANES study. Stroke, v. 49, n. 12, p. 2933-2944, 2018. DOI: https://doi.org/10.1161/STROKEAHA.118.020232
MELGAARD, Line et al. Effectiveness and safety of NOAC versus warfarin in patients with atrial fibrillation and aortic stenosis. Journal of the American Heart Association, v. 10, n. 23, p. e022628, 2021. DOI: https://doi.org/10.1161/JAHA.121.022628
MIHAILA, Romeo Gabriel. Warfarin involvement, in comparison to NOACs, in the development of systemic atherosclerosis. Biomedical Papers of the Medical Faculty of Palacky University in Olomouc, v. 166, n. 2, 2022. DOI: https://doi.org/10.5507/bp.2022.008
NAM, Ki-Woong et al. Effectiveness and safety of secondary prevention of non-vitamin K oral anticoagulants use by drug type in Asian patients. International Journal of Stroke, v. 18, n. 8, p. 927-936, 2023. DOI: https://doi.org/10.1177/17474930231176715
NEPAL, Gaurav et al. Safety and efficacy of Direct Oral Anticoagulants in cerebral venous thrombosis: A meta‐analysis. Acta Neurologica Scandinavica, v. 145, n. 1, p. 10-23, 2022. DOI: https://doi.org/10.1111/ane.13506
OSHO, Asishana A. et al. Rationale and Design of the Randomized Controlled Trial of New Oral Anticoagulants Versus Warfarin for Post Cardiac Surgery Atrial Fibrillation: The NEW-AF Trial. Annals of Surgery, v. 276, n. 1, p. 200-204, 2022. DOI: https://doi.org/10.1097/SLA.0000000000004459
PATEL, Priya et al. NOACs vs. warfarin for stroke prevention in nonvalvular atrial fibrillation. Cureus, v. 9, n. 6, 2017. DOI: https://doi.org/10.7759/cureus.1395
PIEPIORKA-BRONIECKA, Marta et al. NOAC versus warfarin in the treatment of atrial fibrillation during the first three months after bioprosthetic aortic valve replacement. Cardiology Journal, v. 29, n. 2, p. 355-357, 2022. DOI: https://doi.org/10.5603/CJ.a2021.0158
SCHÄFER, Andreas et al. Anticoagulants for stroke prevention in atrial fibrillation in elderly patients. Cardiovascular drugs and therapy, v. 34, p. 555-568, 2020. DOI: https://doi.org/10.1007/s10557-020-06981-3
SENOO, Keitaro et al. Efficacy and safety of non-vitamin K antagonist oral anticoagulants vs. warfarin in Japanese patients with atrial fibrillation–meta-analysis. Circulation Journal, v. 79, n. 2, p. 339-345, 2015. DOI: https://doi.org/10.1253/circj.CJ-14-1042
STERNE, Jonathan AC et al. Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis. Health Technology Assessment, v. 21, n. 9, 2017. DOI: https://doi.org/10.3310/hta21090
SVENSSON, Peter J.; SJÄLANDER, Anders. NOAC in everyday clinical practice. Lakartidningen, v. 112, p. DH3X-DH3X, 2015.
VERDECCHIA, Paolo et al. Why switch from warfarin to NOACs?. Internal and emergency medicine, v. 11, p. 289-293, 2016. DOI: https://doi.org/10.1007/s11739-016-1411-0
VIRANI, Salim S. et al. "Heart disease and stroke statistics—2020 update: a report from the American Heart Association." Circulation, v. 141, n. 9, p. e139-e596, 2020.
WANG, Xinyi et al. Efficacy and Safety of Oral Anticoagulants in Older Adult Patients with Atrial Fibrillation: Pairwise and Network Meta-Analyses. Journal of the American Medical Directors Association, 2023. DOI: https://doi.org/10.1016/j.jamda.2023.05.010
WU, Victor Chien-Chia et al. Efficacy and safety of NOAC versus warfarin in AF patients with left atrial enlargement. Plos one, v. 15, n. 12, p. e0243866, 2020. DOI: https://doi.org/10.1371/journal.pone.0243866
YAO, Xiaoxi et al. Renal outcomes in anticoagulated patients with atrial fibrillation. Journal of the American College of Cardiology, v. 70, n. 21, p. 2621-2632, 2017. DOI: https://doi.org/10.1016/j.jacc.2017.09.1087
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