Allali Asma, Oukass Siham, Mouamin Maryam, Yahyaoui Hicham, Chakour Mohamed, Morocco
Classical oral anticoagulation, mediated by vitamin K antagonists, has numerous disadvantages, in particular that of a high risk of bleeding. In this context, new oral anticoagulants, called direct oral anticoagulants (DOA), have appeared in the therapeutic arsenal over the last few years and, over the course of clinical studies, are acquiring more and more indications.
Antivitamin K and direct oral anticoagulants are now in competition. The arguments developed around direct oral anticoagulants raise the question of whether vitamin K antagonists should totally disappear in favor of direct oral anticoagulants, or at least keep only the niches left by the contraindications of direct oral anticoagulants. Their arrival on the market and the marketing pressure that accompanied it exacerbated the mistrust at the opposate of the antivitamics K. Direct oral anticoagulants have therefore had the merit of making us think with reason about anticoagulation in general. The central question in this industry-driven debate is: are direct oral anticoagulants better than vitamin K antagonists?
The purpose of this development is to try to bring an objective vision. This is not to denigrate one or the other but to choose between these two families of anticoagulants so that any prescriber can use one or the other knowingly and safely.