Oral Anticoagulants to Reduce the Risk of Stroke in Atrial Fibrillation: How Should a Clinician Choose?

Atrial fibrillation (AF), a common arrhythmia that occurs with increasing frequency in the aging population, is associated with increased mortality and morbidity. To ensure that patients receive adequate anticoagulant prophylaxis, clinical guidelines for anticoagulation advocate use of validated sco...

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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2013-11, Vol.36 (11), p.663-670
Main Authors: Mohammed, Ilyas, Syed, Wajihuddin, Kowey, Peter R.
Format: Article
Language:English
Subjects:
Administration, Oral
Anticoagulants
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Atrial Fibrillation - drug therapy
Cardiac arrhythmia
Drug therapy
Hemorrhage - chemically induced
Humans
Mortality
Patient Selection
Review
Reviews
Risk Assessment
Risk Factors
Stroke - diagnosis
Stroke - etiology
Stroke - prevention & control
Thromboembolism - diagnosis
Thromboembolism - etiology
Thromboembolism - prevention & control
Treatment Outcome
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Summary:Atrial fibrillation (AF), a common arrhythmia that occurs with increasing frequency in the aging population, is associated with increased mortality and morbidity. To ensure that patients receive adequate anticoagulant prophylaxis, clinical guidelines for anticoagulation advocate use of validated scoring systems to stratify patients by cardiovascular risk and predict the individual patient's risk of adverse effects of therapy. Recently approved oral anticoagulants—a direct thrombin inhibitor and the factor Xa inhibitors—may offer advantages over the 50‐year standard, warfarin, for efficacy, safety, and ease of administration. Clinical trial experience with the newly approved agents and others, yet to be approved, will define their relative value in reducing the risk of thromboembolism associated with AF. This article discusses issues that may help clinicians choose among these newer agents and individualize treatment appropriately.
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.22173