Stroke prevention in atrial fibrillation: latest clinical trials and guidelines.

Pharmaceuticals (Basel)

Cardiac Arrhythmias and Electrophysiology, Dante Pazzanese Institute of Cardiology, Sao Paulo 04012-180, Brazil.

Published: April 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.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763643PMC
http://dx.doi.org/10.3390/ph5040384DOI Listing

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