Recent advances in antithrombotic therapy for stroke prevention in patients with atrial fibrillation.

Joshua D Lenchus

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac dysrhythmia and patients with AF have a higher risk for stroke than the general population. The prevalence of AF is increasing, which underscores the importance of understanding the therapeutic options available for stroke prevention in the primary care setting. This article examines evidence for the use of novel oral anticoagulant (OAC) therapy, including the direct thrombin inhibitor dabigatran and the activated factor X inhibitors rivaroxaban and apixaban for stroke prevention in patients with AF. Although warfarin therapy is the gold standard for prevention of stroke, its use is associated with significant challenges related to drug-drug and food-drug interactions. Warfarin use also requires frequent blood monitoring to maintain anticoagulation within a narrow therapeutic window. Overall, the novel OACs are as good as, or better than, warfarin therapy for stroke prevention in patients with AF, and they have a comparable or reduced risk of associated major bleeding. In addition, the novel OACs have fewer drug-drug and food-drug interactions and do not require continuous blood monitoring. Integration of the novel OACs into clinical practice offers patients with AF new treatment options, and as therapeutic use of the novel OACs increases, real-world experience will add to our understanding of the value of these agents.

Original languageEnglish
Pages (from-to)49-60
Number of pages12
JournalHospital practice (1995)
Volume41
Issue number1
StatePublished - Feb 1 2013

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Food-Drug Interactions
Atrial Fibrillation
Stroke
Warfarin
Therapeutics
Factor Xa
Antithrombins
Therapeutic Uses
Pharmaceutical Preparations
Anticoagulants
Cardiac Arrhythmias
Primary Health Care
Hemorrhage
Population

ASJC Scopus subject areas

  • Medicine(all)

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Recent advances in antithrombotic therapy for stroke prevention in patients with atrial fibrillation. / Lenchus, Joshua D.

In: Hospital practice (1995), Vol. 41, No. 1, 01.02.2013, p. 49-60.

Research output: Contribution to journalArticle

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