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Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines
Cardiac Arrhythmias and Electrophysiology, Dante Pazzanese Institute of Cardiology, Sao Paulo 04012-180, Brazil
1506 Bristol Court, Elizabethtown, KY 42701, USA
Department of Medicine, Cardiology Division, Electrophysiology Service, Paulista School of Medicine, UNIFESP, Sao Paulo 04024-002, Brazil
Department of Medicine, Cardiology Division, Arrhythmia Service, McMaster University, Population Health Research Institute, Hamilton, ON L8L 2X2, Canada
* Author to whom correspondence should be addressed.
Received: 15 March 2012; in revised form: 16 March 2012 / Accepted: 28 March 2012 / Published: 5 April 2012
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.
Keywords: atrial fibrillation; anticoagulants; stroke; prevention
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MDPI and ACS Style
Armaganijan, L.; Patel, D.; Dietrich, C.; Morillo, C.A. Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines. Pharmaceuticals 2012, 5, 384-397.
Armaganijan L, Patel D, Dietrich C, Morillo CA. Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines. Pharmaceuticals. 2012; 5(4):384-397.
Armaganijan, Luciana; Patel, Dimpi; Dietrich, Cristiano; Morillo, Carlos A. 2012. "Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines." Pharmaceuticals 5, no. 4: 384-397.