Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines

• Main Authors: Luciana Armaganijan (Author), Cristiano Dietrich (Author), Dimpi Patel (Author), Carlos A. Morillo (Author)
• Format: Book
• Published: MDPI AG, 2012-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/ph5040384; 1424-8247
• Keywords: atrial fibrillation; anticoagulants; stroke; prevention; Medicine; R; Pharmacy and materia medica; RS1-441
• Source: Pharmaceuticals, Vol 5, Iss 4, Pp 384-397 (2012)

Atrial Fibrillation (AF) is the most common sustained arrhythmia and 1/6 strokes is attributed to AF. The cornerstone of treatment remains maintaining sinus rhythm or appropriate ventricular rate control in addition to prevention of stroke. Oral anticoagulation therapy (OAC) with vitamin K antagonists (VKAs) has been the gold standard for almost 50 years and a significant reduction in the risk of stroke in patients with AF has been demonstrated. Nonetheless, only 50% of patients with guideline recommendations for OAC treatment actually receive VKAs and half of these will discontinue therapy within 3 to 5 years with only another half achieving therapeutic ranges more than 50% of the time. The aforementioned limitations in addition with frequent blood monitoring have prompted the development of a series of new OAC therapies. The present review focuses on the current pharmacological management for stroke prevention in patients with AF based on current and emerging evidence.