2024 Volume 20 Issue 1 Pages 4-9
The incidence of cerebral infarction in patients with non-valvular atrial fibrillation is 5% per year on average, and since there are currently estimated to be more than 800,000 patients with atrial fibrillation in Japan, the use of oral anticoagulants is an important clinical issue. For many years, the only oral anticoagulant used in Japan was warfarin, but the use of direct oral anticoagulants (DOACs) has increased rapidly since they became available due to their superior efficacy in preventing thrombosis. The number of patients using these drugs has also increased, but this has been accompanied by an increase in bleeding-related adverse events and cerebral infarction. On the other hand, two types of neutralizers are now available to prevent hemorrhages in patients receiving DOACs in the preoperative period or in emergencies. In this article, we discuss the predicted anticoagulant effect of one DOAC, apixaban, and the characteristics of DOAC neutralizers.
