title: Prevention of stroke in patients with atrial fibrillation: anticoagulant and antiplatelet options.
abstract: As the population ages, the prevalence of atrial fibrillation (AF) continues to rise. The most feared complication of this common cardiac arrhythmia is cardioembolic stroke. Strokes related to AF are associated with greater morbidity and mortality than ischemic strokes of most other etiologies and impose a substantial economic burden on healthcare systems around the world. Until recently, warfarin was the sole anticoagulant proven effective for stroke prevention patients with AF at elevated risk, but its narrow therapeutic margin and variable dose response limited clinical utility. The emergence of new anticoagulants that offer equal or superior efficacy, greater safety and the convenience of fixed oral dosing may make warfarin the less preferred option. This review provides an update on recent advancements in antithrombotic therapy for stroke prevention in patients with AF.
authors.affiliation: The Cardiovascular Institute, Mount Sinai Medical Center, Box 1030, Fifth Avenue at 100th Street, New York, NY 10029-6574, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Varughese
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Halperin
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D001562:Benzimidazoles / Q000627:therapeutic use; D000077144:Clopidogrel; D000069604:Dabigatran; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011720:Pyrazoles / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use; D018570:Risk Assessment; D000069552:Rivaroxaban; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control*; D013844:Thiazoles / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000379:methods*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use; D015091:beta-Alanine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D009025:Morpholines; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; D014859:Warfarin; D000069552:Rivaroxaban; D000077144:Clopidogrel; D000069604:Dabigatran; C552171:edoxaban; D013988:Ticlopidine; D001241:Aspirin