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Lower dose direct oral anticoagulants and improved survival: A combined analysis in patients with established atherosclerosis
Anti-thrombotic and anti-coagulation effects of direct oral anticoagulants (DOACs) are dose-dependent [1–5]. Conversely, the benefit from higher dose DOACs is counterbalanced by a dose-dependent risk of bleeding [4]. Currently recommended regimens are the result of pre-clinical [5,6] and phase III studies [1,2,7–12] in which various doses of DOACs were investigated and compared to standard of care in various conditions such as acute or stable coronary artery disease (CAD), peripheral artery disease (PAD), non-valvular atrial fibrillation (AF), and venous thromboembolism (VTE).Oral anticoagulants in thrombotic antiphospholipid syndrome: Leave the old road for a new trail?
I read with interest the meta-analysis by Pau Cerdà et al. on direct oral anticoagulants compared to vitamin K antagonists in antiphospholipid syndrome (APS) [1]. Overall, I agree with the Authors’ conclusions that the use of rivaroxaban in APS patients is associated with an increase rate of recurrences, at least in those with an arterial index event or triple positivity for antiphospholipid (aPL) antibodies. However, the statement that rivaroxaban and VKAs are equally effective in preventing venous thromboembolism must be taken with caution.
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