[Stroke prevention in patients with atrial fibrillation].

Rev Med Suisse

Unités de neurosonologie et neurologie vasculaire, Division de neurologie, Département des neurosciences cliniques, HUG et Faculté de médecine, 1211 Genève 14.

Published: April 2017

Oral anticoagulation with vitamin K antagonists (VKA) was the cornerstone of stroke prevention in atrial fibrillation (AF). This review article presents the state of the art, with regard to the treatment options developed over the past few years, the new oral anticoagulants (NOAC). A search in PubMed for relevant published studies has been performed. Dabigatran and apixaban were superior to warfarin to reduce stroke risk or systemic embolism ; dabigatran, rivaroxaban and edoxaban were non-inferior. All NOAC are globally non-inferior to warfarin for stroke prevention in non-valvular AF and they have a superior safety profile, with a reduced intracranial bleeding risk. They are now the first choice for treatment.

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