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Open Access 14-05-2024 | Stroke | IM - REVIEW

Factor XI Inhibitors: perspectives in primary and secondary prevention of ischemic stroke

Authors: Domenico Prisco, Maria Canfora, Matteo Mazzetti, Irene Mattioli, Alessandra Bettiol

Published in: Internal and Emergency Medicine

Abstract

Stroke is one of the most common causes of mortality and disability worldwide. Antithrombotic therapy represents the mainstay in primary and secondary prevention, both in cardioembolic and non-cardioembolic stroke. Particularly, direct oral anticoagulants play a crucial role in atrial fibrillation, the most common cause of cardioembolic stroke, whereas single or dual antiplatelet therapy is preferred in non-cardioembolic stroke. However, the limitations related to the residual risk of cardioembolic or cerebrovascular events, and the risk of major bleeding, still represent unmet medical needs. To overcome them, new drugs inhibiting Factor XI (FXI) and Factor XII have been proposed, with a selective inhibition of contact pathway of coagulation, delineating a new anticoagulant approach. This review provides a summary of the currently available evidence and future perspectives on FXI inhibitors, that can represent an additional therapeutic option in the primary and secondary prevention of cardioembolic and non-cardioembolic ischemic stroke, also in challenging therapeutic contexts.

Graphical Abstract

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Title: Factor XI Inhibitors: perspectives in primary and secondary prevention of ischemic stroke
Authors: Domenico Prisco
Maria Canfora
Matteo Mazzetti
Irene Mattioli
Alessandra Bettiol
Publication date: 14-05-2024
Publisher: Springer International Publishing
Keywords: Stroke
Atrial Fibrillation
Anticoagulant
Apixaban
Direct Oral Anticoagulant
Direct Oral Anticoagulant
Rivaroxaban
Published in: Internal and Emergency Medicine
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-024-03611-w

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