title: Clinical strategies for selecting oral anticoagulants in patients with atrial fibrillation.
abstract: Atrial fibrillation is a common arrhythmia. One of the important aspects of the management of atrial fibrillation is stroke prevention. Warfarin has been the longstanding anticoagulant used for stroke prevention in patients with atrial fibrillation. There are now three novel oral anticoagulants, which have been studied in randomized controlled trials and subsequently approved by the Federal Drug Administration for stroke prevention in patients with atrial fibrillation. Special patient populations, including renal insufficiency, elderly, prior stroke, and extreme body weights, were represented to varying degrees in the clinical trials of the novel oral anticoagulants. Furthermore, there is variation in the pharmacokinetics and pharmacodynamics of each anticoagulant, which affect the patient populations differently. Patients and clinicians are faced with the task of selecting among the available anticoagulants, and this review is designed to be a tool for clinical decision-making.
authors.affiliation: Division of Cardiology, Duke University Medical Center, Duke University Hospital, 2301 Erwin Rd, DUMC 3845, Durham, NC 27710, USA. sean.pokorney@duke.edu
authors.forename: Sean D
authors.initials: SD
authors.lastname: Pokorney
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Sherwood
authors.forename: Richard C
authors.initials: RC
authors.lastname: Becker
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003657:Decision Making; D017277:Drug Approval; D006801:Humans; D020521:Stroke / Q000517:prevention & control; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000925:Anticoagulants