Abstract

Practical approaches to the treatment of atrial fibrillation: focus on stroke prevention using oral anticoagulant drugs

Author(s): Tatjana S Potpara, Marina M Licina, Marija M Polovina

 Atrial fibrillation (AF) confers a significant risk of ischemic stroke, and oral
anticoagulation is the most effective therapy for thromboprophylaxis in AF. Until recently,
vitamin K antagonists (VKAs) were the only available oral anticoagulants. However, numerous
disadvantages of VKAs and anticipated bleeding risk with treatment have resulted in
their substantial underutilization in clinical practice. Recently, the two other classes of oral
anticoagulants – direct thrombin inhibitors (e.g., dabigatran) and direct factor Xa inhibitors
(e.g., rivaroxaban and apixaban) – have emerged as a viable alternative to VKAs for stroke
prevention in AF. In addition, efforts have been made to facilitate the optimal prevention of
AF-related stroke by improvement of both stroke and bleeding risk assessment. In this review,
we summarize the recent advances and discuss the contemporary practical aspects of stroke
prevention in patients with nonvalvular AF.

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