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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Drug Therapies for Stroke Prevention in Atrial Fibrillation: An Historical Perspective

Albert L Waldo1

  • 1Division of Cardiovascular Medicine, University Hospitals Case Medical Center, 11100 Euclid Avenue, MS LKS 5038, Room 3080, Cleveland, OH 44106, USA.

Cardiac Electrophysiology Clinics
|April 12, 2016
PubMed

Insights

Oral anticoagulants effectively prevent stroke in atrial fibrillation patients. While new options exist, warfarin remains a cost-effective choice, and aspirin

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) poses a significant risk for stroke and systemic embolism.
  • Oral anticoagulants are crucial for managing this risk in high-risk AF patients.

Purpose of the Study:

  • To review the efficacy and safety of various oral anticoagulants.
  • To guide drug selection for stroke prevention in atrial fibrillation.

Main Methods:

  • Review of existing literature on oral anticoagulants.
  • Comparative analysis of warfarin and newer oral anticoagulants.
  • Assessment of aspirin's role in AF management.

Main Results:

  • Oral anticoagulants demonstrate high efficacy and acceptable safety profiles.
  • Newer oral anticoagulants offer advantages over warfarin but warfarin remains a viable, inexpensive option.
  • Aspirin's efficacy in this context is questionable and largely unsupported by guidelines.

Conclusions:

  • Individualized drug selection is paramount for oral anticoagulation in AF.
  • Well-managed warfarin is a cost-effective and acceptable treatment.
  • The role of aspirin in preventing AF-related thromboembolism is minimal.

Keywords:
Atrial fibrillationOral anticoagulantsStroke prevention

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