Stroke Prevention in Atrial Fibrillation: Where Are We Now?

Overview

Journal Clin Med Insights Cardiol

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2012 Mar 13

PMID 22408371

Citations 5

Authors

Yousif Ahmad

Gregory Y H Lip

Affiliations

Soon will be listed here.

Abstract

Atrial fibrillation is the commonest arrhythmia worldwide and is a growing problem. AF is responsible for 25% of all strokes, and these patients suffer greater mortality and disability. Warfarin has traditionally been the only successful therapy for stroke prevention, but its limitations have resulted in underutilisation. Major progress has been made in AF research, leading to improved management strategies. Better risk stratification permits identification of truly low-risk patients who do not require anticoagulation and we are able to simplify ourevaluation of a patient's bleeding risk.The advent of novel anticoagulants means warfarin is no longer the only choice for stroke prophylaxis. These drugs circumvent many of warfarin's inconveniences, but onlylong-term study and use will conclusively demonstrate how they compare to warfarin. The landscape of stroke prevention in AF has changed with effective alternatives to warfarin available for the first time in 60 years-but each new option brings new considerations.

Citing Articles

A Cohort Study on the Safety and Efficacy of Warfarin and Rivaroxaban in Anticoagulant Therapy in Patients with Atrial Fibrillation Study.

Wang L, Yao W Biomed Res Int. 2022; 2022:4611383.

PMID: 35845939 PMC: 9283039. DOI: 10.1155/2022/4611383.

A single-arm feasibility cohort study of rivaroxaban in antiphospholipid syndrome.

Legault K, Blostein M, Carrier M, Khan S, Schulman S, Shivakumar S Pilot Feasibility Stud. 2020; 6:52.

PMID: 32346486 PMC: 7183116. DOI: 10.1186/s40814-020-00594-1.

Stability of High-Quality Warfarin Anticoagulation in a Community-Based Atrial Fibrillation Cohort: The Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.

Dallalzadeh L, Go A, Chang Y, Borowsky L, Fang M, Singer D J Am Heart Assoc. 2016; 5(7).

PMID: 27451456 PMC: 5015384. DOI: 10.1161/JAHA.116.003482.

Thromboprophylaxis of elderly patients with AF in the UK: an analysis using the General Practice Research Database (GPRD) 2000-2009.

Scowcroft A, Lee S, Mant J Heart. 2012; 99(2):127-32.

PMID: 23086966 PMC: 3551210. DOI: 10.1136/heartjnl-2012-302843.

Stroke prevention in atrial fibrillation: concepts and controversies.

Ahmad Y, Lip G Curr Cardiol Rev. 2012; 8(4):290-301.

PMID: 22920480 PMC: 3492813. DOI: 10.2174/157340312803760820.

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