title: Stroke prevention in atrial fibrillation: latest clinical trials and guidelines.
abstract: Atrial Fibrillation (AF) is the most common sustained arrhythmia and 1/6 strokes is attributed to AF. The cornerstone of treatment remains maintaining sinus rhythm or appropriate ventricular rate control in addition to prevention of stroke. Oral anticoagulation therapy (OAC) with vitamin K antagonists (VKAs) has been the gold standard for almost 50 years and a significant reduction in the risk of stroke in patients with AF has been demonstrated. Nonetheless, only 50% of patients with guideline recommendations for OAC treatment actually receive VKAs and half of these will discontinue therapy within 3 to 5 years with only another half achieving therapeutic ranges more than 50% of the time. The aforementioned limitations in addition with frequent blood monitoring have prompted the development of a series of new OAC therapies. The present review focuses on the current pharmacological management for stroke prevention in patients with AF based on current and emerging evidence.
authors.affiliation: Cardiac Arrhythmias and Electrophysiology, Dante Pazzanese Institute of Cardiology, Sao Paulo 04012-180, Brazil. morillo@hhsc.ca.
authors.forename: Luciana
authors.initials: L
authors.lastname: Armaganijan
authors.forename: Dimpi
authors.initials: D
authors.lastname: Patel
authors.forename: Cristiano
authors.initials: C
authors.lastname: Dietrich
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morillo