Key result
Non-vitamin K antagonist oral anticoagulants may offer an opportunity to modify the approach to sport activity in patients requiring anticoagulation compared to vitamin-K antagonists.
Why the study?
Current recommendations for oral anticoagulants in athletes reflect older VKA-based limitations, but non-vitamin K antagonist oral anticoagulants may provide an opportunity to modify this approach while minimizing bleeding risk.
Do non-vitamin K antagonist oral anticoagulants improve the ability to safely practice sports compared to vitamin-K antagonists in patients requiring anticoagulation?
Do non-vitamin K antagonist oral anticoagulants improve the ability to safely practice sports compared to vitamin-K antagonists in patients requiring anticoagulation?
NOACs may offer a safer alternative to VKAs for patients requiring anticoagulation who wish to participate in sports, potentially allowing for more flexible recommendations.
Should not yet change sports counseling for anticoagulated patients; leaves open confirmation in prospective trials.
Physical activity is worldwide recommended for its benefits on cardiovascular system. There is an increasing number of people of all ages that approach sport activity both as leisure time physical activity and as competitive sport. It is always more frequent the request even from older subjects and cardiac patients to be allowed to practice physical activity. Some problems could arise when these subjects present or develop pathologic conditions that require specific pharmacological treatment, in particular an anticoagulation therapy. This review focalizes on the management of oral anticoagulant therapy (OAT) in patients practicing sport activity, especially due to atrial fibrillation and deep vein thrombosis, which represent two highly prevalent conditions, particularly with increasing age. Official recommendations in this field may appear limiting for patients, forbidding in the majority of cases sports at risk of trauma and consequent bleeding. These recommendations still resent the heritage of the "traditional" management of OAT, mainly represented by vitamin-K antagonists (VKAs). The non-vitamin K antagonist oral anticoagulants, with their more favorable pharmacokinetic-pharmacodynamic profile compare to VKAs, may now represent an opportunity to modify the approach to sport activity in patients with an indication to OAT. This review of the literature deals with possible strategies to overcome the present limitations for OAT subjects willing to pursue a healthy lifestyle, that include sport activity, minimizing at the same time their risk of bleeding.
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Romano et al. (2020) conducted a review in Atrial fibrillation and deep vein thrombosis. Non-vitamin K antagonist oral anticoagulants vs. Vitamin-K antagonists was evaluated. Non-vitamin K antagonist oral anticoagulants may offer an opportunity to modify the approach to sport activity in patients requiring anticoagulation compared to vitamin-K antagonists.
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