NOACS in the Chronic Renal, Hepatic and Obstructive Pulmonary Diseases

Non-vitamin K antagonist oral anticoagulants (NOACs) are used worldwide for the management of thrombotic episodes in patients with atrial fibrillation (AF) or venous thromboembolism (VTE). Patients with chronic kidney disease (CKD), chronic liver insufficiency (CLI), and chronic obstructive pulmonary disease (COPD) are prone to develop AF and VTE in the long term. Specifically, both diseases, CKD and CLI are at increased risk of developing thrombotic and bleeding episodes. This leads to cautious dosing of each NOAC to target the thrombotic risk and prevent the bleeding risk. This manuscript will help physicians understand the dose regimen for prescribing NOACs in the above-mentioned chronic conditions.