[Atrial fibrillation: Thromboembolic risk factor or marker? From concept to therapy]

Area of Science:

• Cardiology
• Neurology
• Pharmacology

Background:

• Atrial fibrillation is a major cause of stroke.
• Vitamin K antagonists were historically used but are difficult to manage.
• Direct oral anticoagulants (DOACs) have emerged as a safer alternative.

Purpose of the Study:

• To review the role of anticoagulation in atrial fibrillation.
• To discuss the benefits and limitations of DOACs.
• To explore current controversies in anticoagulation management.

Main Methods:

• Review of existing literature on anticoagulation in atrial fibrillation.
• Comparison of direct oral anticoagulants with vitamin K antagonists.
• Analysis of recent findings on the relationship between atrial fibrillation and stroke.

Main Results:

• DOACs are non-inferior to vitamin K antagonists and reduce intracranial hemorrhages.
• Anticoagulation is indicated for most atrial fibrillation patients.
• Recent evidence suggests atrial fibrillation may be a marker rather than a direct cause of stroke in some cases.

Conclusions:

• DOACs represent a significant advancement in stroke prevention for atrial fibrillation.
• Further research is needed to address remaining questions regarding anticoagulation strategies.
• The role of atrial fibrillation as a marker of thromboembolic risk warrants further investigation.