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This section covers the role of Factor Xa in coagulation, and discusses the use of direct and indirect Factor Xa inhibitors as anticoagulants
Coagulation is initiated when small amounts of thrombin are generated in response to vascular injury and platelets become activated1,2
Factor Xa is positioned at the start of the common pathway of coagulation. As the amount of serine protease is amplified at each step of the cascade, it has been hypothesized that the selective inhibition of coagulation factors above thrombin might be a highly effective antithrombotic strategy.
Professor of Medicine and former Director of the Haemostasis and Thrombosis Research Group at the Institute for Experimental Oncology and Therapy Research, Technical University of Munich, Germany
Rivaroxaban | Apixaban | Edoxaban | |
---|---|---|---|
Prevention of VTE in patients undergoing elective hip or knee replacement surgery | ✓ | ✓ | ✓ (Japan only) |
Treatment of DVT and PE and prevention of recurrent DVT and PE | ✓a | ✓a | ✓ |
Prevention of stroke and systemic embolism in patients with NVAF with ≥1 risk factors | ✓ | ✓ | ✓ |
Secondary prevention of ACS | ✓b | x | x |
Prevention of atherothrombotic events in adult patients with CAD or symptomatic PAD at high risk of ischaemic eventsc | ✓ | x | x |
aCan be used without pre-treatment with parenteral anticoagulant; bIn patients with elevated cardiac biomarkers and no prior stroke or TIA, and co-administered with ASA or ASA plus clopidogrel or ticlopidine; cco-administered with ASA