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- Ultra-low-dose direct oral anticoagulants in vulnerable patients with atrial fibrillation or coronary artery disease
- Dae young Cheon, Jae Hyuk Choi
- Cardiovasc Prev Pharmacother. 2025;7(2):38-43. Published online April 25, 2025
- DOI: https://doi.org/10.36011/cpp.2025.7.e5
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Abstract
PDF - Direct oral anticoagulants (DOACs) have largely supplanted warfarin for stroke prevention in atrial fibrillation due to their superior safety and efficacy profiles. Although standard dosing regimens are well-established, lower doses—often referred to as ultra-low-dose (ULD) DOACs—have been investigated in selected populations to balance thrombotic and bleeding risks. The concept of ULD DOACs was first introduced in the 2013 European Heart Rhythm Association Practical Guide specifically for post‐acute coronary syndrome patients with residual thrombotic risk. Clinical trials, including ATLAS ACS-TIMI 51 and COMPASS, demonstrated that rivaroxaban 2.5 mg twice a day reduced ischemic events when combined with aspirin, although this benefit was accompanied by an increased risk of major bleeding. Similarly, the ELDERCARE-AF trial revealed that edoxaban 15 mg once a day effectively prevented stroke in frail older patients. Conversely, evidence supporting ULDs of dabigatran and apixaban remains limited. Despite their potential benefits, inappropriate dose reductions based on subjective physician judgment rather than rigorous clinical guidelines may result in suboptimal anticoagulation and a heightened risk of thromboembolic events. This review explores the indications, supporting evidence, and potential risks associated with ULD DOACs, underscoring the need for well-designed studies to establish clear guidelines.
- Adverse effects of statin therapy and their treatment
- Dae Young Cheon, Sang-Ho Jo
- Cardiovasc Prev Pharmacother. 2022;4(1):1-6. Published online January 20, 2022
- DOI: https://doi.org/10.36011/cpp.2022.4.e4
- 24,795 View
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- 3 Citations
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Abstract
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- Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.
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- Efficacy, side effects, adherence, affordability, and procurement of dietary supplements for treating hypercholesterolemia: a narrative review
Isabel von Känel-Cordoba, Katharina Wirnitzer, Katja Weiss, Pantelis T. Nikolaidis, Asli Devrim-Lanpir, Lee Hill, Thomas Rosemann, Beat Knechtle
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef - The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
Current Issues in Molecular Biology.2023; 45(4): 3146. CrossRef - The effects of L-carnitine in reducing hepatotoxicity of statins in rats
Doaa Ibrahim, Shahad Bader, Omar Bader
Medicinski casopis.2023; 57(3): 59. CrossRef
- Efficacy, side effects, adherence, affordability, and procurement of dietary supplements for treating hypercholesterolemia: a narrative review
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