Prevention of stroke in patients with atrial fibrillation: the role of new antiarrhythmic and antithrombotic drugs.
BACKGROUND
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is associated with increased cardiovascular mortality and morbidity, including stroke.


RESULTS
Rate or rhythm control and prevention of thromboembolism with oral anticoagulants are the main management objectives for patients with AF. Until recently, rhythm control studies did not show prevention of cardiovascular complications. However, dronedarone, a novel antiarrhythmic drug, has been shown to decrease stroke risk by 34% (p = 0.027). In addition, the Randomized Evaluation of Long-Term Anticoagulant Therapy trial showed significant stroke reductions with the anticoagulant dabigatran 150 mg b.i.d. compared with adjusted-dose warfarin (the results for dabigatran 110 mg b.i.d. were similar to warfarin).


CONCLUSIONS
Novel antithrombotic agents and antiarrhythmic agents with cardiovascular prophylactic properties may enhance the management of stroke risk in patients with AF.
Röther
Joachim
J
Johannes Wesling Klinikum Minden, Hannover Medical School, Minden, Germany. j.roether@asklepios.com
Crijns
Harry
H
D000638:Amiodarone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D001562:Benzimidazoles / Q000627:therapeutic use; D000069604:Dabigatran; D000077764:Dronedarone; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D011725:Pyridines / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*
D000889:Anti-Arrhythmia Agents; D001562:Benzimidazoles; D005343:Fibrinolytic Agents; D011725:Pyridines; D000069604:Dabigatran; D000077764:Dronedarone; D000638:Amiodarone