�nme klinik prati�inde NOAK kullan�m�: T�rk Beyin Damar Hastal�klar� Derne�i Uzman G�r���

Acar, Bilgehan; Akp�nar, �etin K�r�ad; Alioglu, Zekeriya; Arlier, Zulfikar; Arsava, Ethem Murat; Ayta�, Emrah; Ba�, Demet Funda; Baydemir, Recep; �abalar, Murat; �evik, Mehmet U�ur; Eren, Alper; Giray, Semih; G�ngor, �brahim Levent; G�rka�, Erdem; Kay�m Y�ld�z, �zlem; Kozak, Hasan H�seyin; Midi, �pek; Milanl�o�lu, Aysel; Nazliel, Bijen; Topcuoglu Ve Ark., Mehmet Akif

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�nme klinik prati�inde NOAK kullan�m�: T�rk Beyin Damar Hastal�klar� Derne�i Uzman G�r�� [T�rk Beyin Damar Hast Derg]

T�rk Beyin Damar Hast Derg. 2020; 26(3): 190-235 | DOI: 10.5505/tbdhd.2020.26213

�nme klinik prati�inde NOAK kullan�m�: T�rk Beyin Damar Hastal�klar� Derne�i Uzman G�r��

Bilgehan Acar¹, �etin K�r�ad Akp�nar², Zekeriya Alioglu³, Zulfikar Arlier⁴, Ethem Murat Arsava⁵, Emrah Ayta�⁶, Demet Funda Ba�⁷, Recep Baydemir⁸, Murat �abalar⁹, Mehmet U�ur �evik¹⁰, Alper Eren¹¹, Semih Giray¹², �brahim Levent G�ngor¹³, Erdem G�rka�¹⁴, �zlem Kay�m Y�ld�z¹⁵, Hasan H�seyin Kozak¹⁶, �pek Midi¹⁷, Aysel Milanl�o�lu¹⁸, Bijen Nazliel¹⁹, Mehmet Akif Topcuoglu Ve Ark.⁵
¹Sakarya �niversitesi E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, Sakarya
²Samsun E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, Samsun
³Karadeniz Teknik �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Trabzon
⁴T.C. Sa�l�k Bakanl�� Adana �ehir E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, Adana
⁵Hacettepe �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Ankara
⁶F�rat �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Elaz��
⁷Tepecik E�itim ve Ara�t�rma Hastanesi N�roloji Klini�i, �zmir
⁸Erciyes �niveristesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Kayseri
⁹T.C. Sa�l�k Bakanl�� Ba�ak�ehir �am ve Sakura �ehir Hastanesi, N�roloji Klini�i, �stanbul
¹⁰Dicle �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Diyarbak�r
¹¹Atat�rk �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Erzurum
¹²Gaziantep �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Gaziantep
¹³Ondokuz May�s �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Samsun
¹⁴Kartal Dr. L�tfi K�rdar �ehir Hastanesi, N�roloji Klini�i, �stanbul
¹⁵Cumhuriyet �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Sivas
¹⁶Necmettin Erbakan �niversitesi Meram T�p Fak�ltesi, N�roloji Anabilim Dal�, Konya
¹⁷Marmara �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, �stanbul
¹⁸Y�z�nc� Y�l �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Van
¹⁹Gazi �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Ankara

Non-vitamin K oral antikoag�lanlar�n (NOAK) atrial fibrilasyonda inmenin �nlenmesi amac�yla on y�l� a�an bir s�redir ba�ar� ile kullan�ld�� a��kt�r. Varfarine g�re belirgin derecede az kanamaya yol a�malar� ve inmeyi de e�it veya daha fazla oranda �nleyebilmeleri yan� s�ra kolay kullan�m �zellikleri primer proflakside atrial fibrilasyona ba�l� inmeyi azaltma konusunda �ne ��kmaktad�r. Bunlar ayn� zamanda genel inme prevalans�n�n azalmas� anlam�na gelmektedir. Yani AF nedenli inmenin engellenmesi toplum sa�l�� i�in �a�da� bir gereklilik olarak alg�lanmal�d�r. �nme klinik prati�inde kardiyoloji uzmanlar� ile birlikte bu ba�lamda �aba sarf eden n�roloji uzmanlar� i�in T�rk Beyin Damar Hastal�klar� Derne�i bu uzman g�r��n� haz�rlad�. G�r��ler NOAK grubu ila�lar�n kullan�m�nda s�k�a kar��la��lan sorunlar ve bu problemler i�in g�ncel ��z�m �nerilerini i�ermektedir.

Anahtar Kelimeler: Serebral embolizm, emboli, inme, kardioemboli, paroksismal, atrial fibrilasyon, korunma.

Use of NOAC in clinical practice of stroke: Expert Opinion of the Turkish Society of Cerebrovascular Diseases

Bilgehan Acar¹, �etin K�r�ad Akp�nar², Zekeriya Alioglu³, Zulfikar Arlier⁴, Ethem Murat Arsava⁵, Emrah Ayta�⁶, Demet Funda Ba�⁷, Recep Baydemir⁸, Murat �abalar⁹, Mehmet U�ur �evik¹⁰, Alper Eren¹¹, Semih Giray¹², �brahim Levent G�ngor¹³, Erdem G�rka�¹⁴, �zlem Kay�m Y�ld�z¹⁵, Hasan H�seyin Kozak¹⁶, �pek Midi¹⁷, Aysel Milanl�o�lu¹⁸, Bijen Nazliel¹⁹, Mehmet Akif Topcuoglu Ve Ark.⁵
¹Sakarya University Training and Research Hospital, Neurology Clinic, Sakarya, Turkey
²Samsun Training and Research Hospital, Neurology Clinic, Sakarya, Turkey
³Karadeniz Technical University Faculty of Medicine, Department of Neurology, Trabzon, Turkey
⁴T.C. Ministry of Health Adana City Training and Research Hospital, Neurology Clinic, Adana, Turkey
⁵Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey
⁶F�rat University Faculty of Medicine, Department of Neurology, Elaz��, Turkey
⁷Tepecik Training and Research Hospital, Neurology Clinic, �zmir, Turkey
⁸Erciyes University Faculty of Medicine, Department of Neurology, Kayseri, Turkey
⁹T.C. Ministry of Health Ba�ak�ehir �am And Sakura City Hospital, Neurology Clinic, �stanbul, Turkey
¹⁰Dicle University Faculty of Medicine, Department of Neurology, Diyarbak�r, Turkey
¹¹Atat�rk University Faculty of Medicine, Department of Neurology, Erzurum, Turkey
¹²Gaziantep University Faculty of Medicine, Department of Neurology,Gaziantep, Turkey
¹³Ondokuz May�s University Faculty of Medicine, Department of Neurology Samsun, Turkey
¹⁴Kartal Dr. L�tfi K�rdar City Hospital, Neurology Clinic, �stanbul, Turkey
¹⁵Cumhuriyet University, Faculty of Medicine, Department of Neurology, Sivas, Turkey
¹⁶Necmettin Erbakan University, Meram Faculty of Medicine, Department of Neurology, Konya, Turkey
¹⁷Marmara University Faculty of Medicine, Department of Neurology, �stanbul, Turkey
¹⁸Y�z�nc� Y�l University, Faculty of Medicine, Department of Neurology, Van, Turkey
¹⁹Gazi University Faculty of Medicine, Department of Neurology, Ankara, Turkey

It is clear that nonvitamin K oral anticoagulants (NOACs) have been used successfully for more than ten years to prevent stroke in atrial fibrillation. In addition to the fact that they cause significantly less bleeding compared to warfarin and can prevent stroke equally or more, their easy-to-use features stand out in reducing stroke due to atrial fibrillation in primary prophylaxis. These also mean a decrease in the overall prevalence of stroke. For sure, prevention of AF-induced stroke should be perceived as a contemporary requirement for public health. Turkish Society of Cerebrovascular Diseases has prepared this expert opinion for neurologists who strive for this purpose together with cardiologists in the clinical practice of stroke. The article contains frequently encountered problems in the use of NOACs and current solutions for these problems.

Keywords: Cerebral embolism, emboli, stroke, cardioembolism, paroxysmal, atrial fibrillation, prevention.

Bilgehan Acar, �etin K�r�ad Akp�nar, Zekeriya Alioglu, Zulfikar Arlier, Ethem Murat Arsava, Emrah Ayta�, Demet Funda Ba�, Recep Baydemir, Murat �abalar, Mehmet U�ur �evik, Alper Eren, Semih Giray, �brahim Levent G�ngor, Erdem G�rka�, �zlem Kay�m Y�ld�z, Hasan H�seyin Kozak, �pek Midi, Aysel Milanl�o�lu, Bijen Nazliel, Mehmet Akif Topcuoglu Ve Ark.. Use of NOAC in clinical practice of stroke: Expert Opinion of the Turkish Society of Cerebrovascular Diseases. T�rk Beyin Damar Hast Derg. 2020; 26(3): 190-235

Sorumlu Yazar: Mehmet Akif Topcuoglu Ve Ark., T�rkiye
Makale Dili: T�rk�e

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�nme klinik prati�inde NOAK kullan�m�: T�rk Beyin Damar Hastal�klar� Derne�i Uzman G�r���

Use of NOAC in clinical practice of stroke: Expert Opinion of the Turkish Society of Cerebrovascular Diseases

�nme klinik prati�inde NOAK kullan�m�: T�rk Beyin Damar Hastal�klar� Derne�i Uzman G�r��