TY - JOUR
T1 - Use of rivaroxaban in patients with stroke
AU - Toni, Danilo
AU - Carolei, Antonio
AU - Caso, Valeria
AU - Consoli, Domenico
AU - Del Sette, Massimo
AU - Inzitari, Domenico
AU - Melis, Maurizio
AU - Micieli, Giuseppe
AU - Provinciali, Leandro
AU - Ricci, Stefano
AU - Santalucia, Paola
AU - Toso, Vito
PY - 2017/2/25
Y1 - 2017/2/25
N2 - Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage. Since data from clinical trials and real-life data are missing in some clinical situations, strong recommendations are not always available. Nevertheless, practical guidelines should be adopted to maximize benefits from this oral anti-coagulant.
AB - Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage. Since data from clinical trials and real-life data are missing in some clinical situations, strong recommendations are not always available. Nevertheless, practical guidelines should be adopted to maximize benefits from this oral anti-coagulant.
KW - Anti-coagulants
KW - Atrial fibrillation
KW - Intracerebral hemorrhage
KW - Ischemic stroke
KW - Rivaroxaban
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U2 - 10.1007/s10072-017-2855-3
DO - 10.1007/s10072-017-2855-3
M3 - Article
AN - SCOPUS:85013769552
SP - 1
EP - 10
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
ER -