Stroke Prevention in Atrial Fibrillation: Focus on Latin America

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• Atrial fibrillation (AF) is a common arrhythmia, with rising prevalence in Latin America due to aging and hypertension.
• This leads to increased stroke incidence and mortality in the region.
• Effective anticoagulation is crucial for stroke prevention in AF patients.

Purpose of the Study:

• To provide a contemporary overview of anticoagulants for stroke prevention in AF patients.
• To discuss the challenges and limitations of current anticoagulation strategies in Latin America.
• To highlight the potential of non-VKA oral anticoagulants (NOACs).

Main Methods:

• Literature review of anticoagulation strategies for AF.
• Analysis of VKA (warfarin), aspirin, and NOAC use in Latin America.
• Discussion of clinical factors influencing anticoagulant choice.

Main Results:

• Vitamin K antagonists (VKAs) and aspirin are common but have limitations: warfarin requires monitoring and has unpredictable pharmacokinetics; aspirin has bleeding risks and lower efficacy.
• A significant proportion of AF patients in Latin America do not receive anticoagulation.
• Non-VKA oral anticoagulants (NOACs) offer potential benefits like reduced monitoring needs and lower bleeding risk.

Conclusions:

• Current anticoagulation practices in Latin America for AF stroke prevention have significant limitations.
• NOACs present a promising alternative to VKAs and aspirin.
• Further research is needed to optimize anticoagulant selection for the Latin American population to reduce AF-associated stroke burden.