New drugs that inhibit blood clotting (NOAC) also called direct action (ADA) have shown in several clinical trials to be effective in preventing embolic events and stroke in patients with non-valvular atrial fibrillation. They are studies that patient meets both primary and secondary prevention and has shown a superiority over warfarin.

   Well it is known for its effective security given the low risk of   systemic and brain hemorrhage, both were lower compared to warfarin.

   Of the two groups of drugs currently commercialized: anti-Xa (edoxaban, apixaban and rivaroxaban) and anti trombine-II (dabigatran), apixaban has a better safety profile in terms of lower risk bleeding and dose dabigatran 150 great  had higher superiority than warfarin about decrease embolic events. Rivaroxaban has the advantage of being administered once a day while the above are given in two daily dose.  However in stroke Dabigatran has a important role due it has an antidote (Praxbind) that can reverse anticoagulant effect in case of hemorrhage or to start rtPA in rare case of ischemic stroke.

This NOACs or DDA don’t alter the levels of coagulation test so it is recommended only in patients considered “compliant” with little chance of forgetting medication.