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ATRIUM Cardiology Collaborative

We can’t help but notice the pervasive use of the term “NOAC” in practice as well as on recent podcasts and in online articles. The Institute for Safe Medication Practices (ISMP) lists “NOAC” as an abbreviation that “should never be used when communicating medical information” on their List of Error-Prone Abbreviations.

Additionally, the International Society on Thrombosis and Haemostasis (ISTH) released a statement in 2015 with the following 3 recommendations:

  1. We suggest that consensus be reached on a single term to be used for describing the direct oral FIIa and FXa inhibitors.
  2. We recommend that a single term be used consistently for all oral direct anticoagulants that have inherently different mechanisms and clinical properties from those of vitamin K antagonists.
  3. We suggest that the abbreviation NOAC should not be used to describe any class of oral anticoagulant.

While “NOAC” was used frequently when non-vitamin K antagonists first came to market, one of the most cited reasons to avoid this term is that it may be misconstrued to mean “no anticoagulation”, leading to potentially harmful consequences for patients. As such, we agree with the recommendations above and prefer that clinicians refrain from using this term.

References:

  1. ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations. Horsham (PA): Institute for Safe Medication Practices. 2017 [cited 2019 Jun 26].
  2. Barnes GD, et al. Recommendation on the nomenclature for oral anticoagulants: communication from the SSC of the ISTH. J Thromb Haemost. 2015 Jun;13(6):1154-1156.
DOAC vs. NOAC: An ATRIUM Perspective

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