Stroke Prevention in Atrial Fibrillation: The Role of Oral Anticoagulation

Med Clin North Am. 2019 Sep;103(5):847-862. doi: 10.1016/j.mcna.2019.05.006.

Abstract

Oral anticoagulation significantly reduces the risk of stroke in patients with atrial fibrillation (AF), and the decision to initiate therapy is based on assessing the patient's yearly risk of stroke. Although warfarin remains the drug of choice in patients with AF and artificial mechanical valves, the novel anticoagulation agents are becoming the drug of choice for all other patients with AF, because of their efficacy, safety, and ease of use. This article summarizes the current evidence for stroke prevention in AF, including valvular AF, subclinical AF, AF in patients with renal insufficiency, as well as stroke prevention around AF cardioversion.

Keywords: Anticoagulation; Atrial fibrillation; NOAC; Stroke prevention; Warfarin.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Clinical Trials as Topic
  • Humans
  • Practice Guidelines as Topic
  • Stroke / etiology
  • Stroke / prevention & control*
  • Warfarin / administration & dosage
  • Warfarin / adverse effects

Substances

  • Anticoagulants
  • Warfarin