-
Research Reports in Clinical Cardiology
- About Dovepress
Open access peer-reviewed scientific and medical journals.
- Open Access
Dove Medical Press is now a member of the Open Access Initiative
- An Author's Guide
A guide to help authors get their paper published.
- Advocacy
Support Open Access and Dove Press
- Reprints
Promotional Article Monitoring - further details
- Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Management of patients with atrial fibrillation at high risk of stroke: current treatment options
Review
(4210) Total Article Views
Authors: Edwards D, Harris K, Mant J
Published Date June 2012 Volume 2012:3 Pages 35 - 47
DOI: http://dx.doi.org/10.2147/RRCC.S16754
Received: | 16 February 2012 |
---|---|
Accepted: | 08 March 2012 |
Published: | 25 June 2012 |
Primary Care Unit, University of Cambridge, Cambridge, UK
Abstract: Atrial fibrillation (AF) is common, and is associated with an increased risk of stroke. Patients' absolute risk of stroke depends on the presence or absence of additional risk factors as well as AF, including prior thromboembolism, increased age, hypertension, diabetes, structural heart disease, and female sex. The risk to benefit ratio of stroke prevention therapy differs according to the patients' absolute risk. There is evidence that even those with an estimated annual stroke risk of 2%–4%, who were once classified as medium risk, would benefit from anticoagulation and should be included in an expanded high-risk category. Alternatives to anticoagulation include the restoration of sinus rhythm and left atrial appendage surgery, but these may not be suitable for many high-risk patients with comorbidities. Antiplatelets are substantially less effective than anticoagulation and cause similar rates of bleeding. Self-monitoring and computerized decision support increases the time in therapeutic range and effectiveness of vitamin K antagonists. Novel oral anticoagulants including dabigatran, rivoraxaban, and apixaban have been shown to be noninferior to warfarin, do not require monitoring, and increase the prescribing options for stroke prevention in AF.
Keywords: stroke prevention, atrial fibrillation, anticoagulants, primary prevention
Post to:
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Readers of this article also read:
- ACC 2014
We will attend the 2014 American College of Cardiology Scientific Session and Expo (ACC) on March 29-31, 2014. Stop by booth 3217 to talk with us.
- The western diet and lifestyle and diseases of civilization
- Aldosterone and aldosterone receptor antagonists in patients with chronic heart failure
- Everolimus-eluting stents in interventional cardiology
- Transitioning from population to individualized preventive cardiology