title: Oral anticoagulants to reduce the risk of stroke in atrial fibrillation: how should a clinician choose?
abstract: Atrial fibrillation (AF), a common arrhythmia that occurs with increasing frequency in the aging population, is associated with increased mortality and morbidity. To ensure that patients receive adequate anticoagulant prophylaxis, clinical guidelines for anticoagulation advocate use of validated scoring systems to stratify patients by cardiovascular risk and predict the individual patient's risk of adverse effects of therapy. Recently approved oral anticoagulants-a direct thrombin inhibitor and the factor Xa inhibitors-may offer advantages over the 50-year standard, warfarin, for efficacy, safety, and ease of administration. Clinical trial experience with the newly approved agents and others, yet to be approved, will define their relative value in reducing the risk of thromboembolism associated with AF. This article discusses issues that may help clinicians choose among these newer agents and individualize treatment appropriately.
authors.affiliation: Department of Cardiology (Mohammed), Lankenau Medical Center and Institute for Medical Research, Wynnewood, Pennsylvania.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Mohammed
authors.forename: Wajihuddin
authors.initials: W
authors.lastname: Syed
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kowey
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
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