[Treatment of atrial fibrillation in dialyzed patients: the role of oral anticoagulants. The cardiologist's point of view]

Abstract

Atrial fibrillation is associated with an increased thromboembolic risk, mainly in the cerebral vascular district. Oral anticoagulant therapy has been demonstrated to be effective in the prevention of thromboembolic events; however, it has some limitations and a relevant bleeding risk. In order to overcome the limits of oral anticoagulant therapy, other antithrombotic strategies have been tested. Antithrombotic therapy in atrial fibrillation must be tailored according to the thromboembolic risk of the single patient and the specific characteristics of the different drugs. Clinicians are supported in their decisions regarding antithrombotic therapy by the current practice guidelines, which are based on different risk indices. This paper will discuss the issues of thromboembolic risk stratification and the different options of antithrombotic strategies, including possible future alternatives.