Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Aug 31:20:56-62.
doi: 10.1016/j.ijcha.2018.08.003. eCollection 2018 Sep.

Oral anticoagulant use for stroke prevention in atrial fibrillation patients with difficult scenarios

Ting-Yung Chang  1   2   3 , Jo-Nan Liao  1   2   3 , Tze-Fan Chao  1   2   3 , Jennifer Jeanne Vicera  1   2   3 , Chin-Yu Lin  1   2   3 , Ta-Chuan Tuan  1   2   3 , Yenn-Jiang Lin  1   2   3 , Shih-Lin Chang  1   2   3 , Li-Wei Lo  1   2   3 , Yu-Feng Hu  1   2   3 , Fa-Po Chung  1   2   3 , Shih-Ann Chen  1   2   3
Affiliations
Review

Oral anticoagulant use for stroke prevention in atrial fibrillation patients with difficult scenarios

Ting-Yung Chang et al. Int J Cardiol Heart Vasc. .

Abstract

Atrial fibrillation (AF) has become the most prevalent arrhythmia and it will increase the risk of ischemic stroke, heart failure, mortality, sudden cardiac death, myocardial infarction, and dementia. Stroke prevention with oral anticoagulant is crucial for management of AF patients. Vitamin K antagonist, which inhibits the clotting factors II, VII, IX and X, has been recommended for stroke prevention for decades. Non-Vitamin K antagonist oral anticoagulants (NOACs), including dabigatran, rivaroxaban, apixaban and edoxaban are at least as effective as warfarin in reducing ischemic stroke with a lower rate of major bleeding. With the increasing prevalence of AF, prescription of the appropriate oral anticoagulants (OACs) according to patient's characteristics becomes a challenge. This review article aims to provide an overview of anticoagulant use in AF patients with difficult scenarios.

Keywords: Atrial fibrillation; Chronic kidney disease; Coronary intervention; Oral anticoagulation; Valvular heart disease.

PubMed Disclaimer

References

    1. January C.T., Wann L.S., Alpert J.S., Calkins H., Cigarroa J.E., Cleveland J.C., Jr., Conti J.B., Ellinor P.T., Ezekowitz M.D., Field M.E., Murray K.T., Sacco R.L., Stevenson W.G., Tchou P.J., Tracy C.M., Yancy C.W., American College of Cardiology/American Heart Association Task Force on Practice Guidelines 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J. Am. Coll. Cardiol. 2014;64:e1–e76. - PubMed
    1. Go A.S., Hylek E.M., Phillips K.A., Chang Y., Henault L.E., Selby J.V., Singer D.E. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–2375. - PubMed
    1. Chao T.F., Liu C.J., Tuan T.C., Chen T.J., Hsieh M.H., Lip G.Y.H., Chen S.A. Lifetime risks, projected numbers, and adverse outcomes in Asian patients with atrial fibrillation: a report from the Taiwan Nationwide AF cohort study. Chest. 2018 Feb;153(2):453–466. - PubMed
    1. Petersen P., Boysen G., Godtfredsen J., Andersen E.D., Andersen B. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet. 1989 Jan 28;1(8631):175–179. - PubMed
    1. Connolly S.J., Ezekowitz M.D., Yusuf S., Eikelboom J., Oldgren J., Parekh A., Pogue J., Reilly P.A., Themeles E., Varrone J., Wang S., Alings M., Xavier D., Zhu J., Diaz R., Lewis B.S., Darius H., Diener H.C., Joyner C.D., Wallentin L., RE-LY Steering Committee and Investigators Dabigatran versus warfarin in patients with atrial fibrillation. N. Engl. J. Med. 2009 Sep 17;361(12):1139–1151. - PubMed

LinkOut - more resources