Selection of medications to prevent stroke among individuals with atrial fibrillation: Update on prevention of stroke in patients with AF

Luca Testa, Alfonso Fasano, Valerio De Sanctis, Roberto Adriano Latini, Azeem Latib, Jacopo Oreglia, Federico De Marco, Mauro Agnifili, Matteo Casavecchia, Giovanni Paolo Talarico, Stefania Lanotte, Samuele Pizzocri, Roberto Mattioli, Massimo Mantica, Francesco Bedogni

Research output: Contribution to journalArticle

Abstract

Opinion statement: Vitamin K antagonists have been the only available orally active anticoagulants for decades. Although effective, their numerous limitations have driven the introduction of new oral anticoagulants (NOAs) that showed effectiveness at fixed doses without the need for routine coagulation monitoring. However, the safety and efficacy observed in controlled clinical trials may be hard to translate in clinical practice. Clinical conditions as well as drug interactions may considerably impact on patient outcomes. Moreover, the inability to monitor the pharmacological activity of NOAs and the absence of any antidote in the setting of bleeding or emergent invasive procedures may limit their use. Vitamin K antagonists will be still used in many circumstances, including patients with an optimal control of the INR, with mechanical heart valves, and other indications for which these new agents have not been investigated. Nevertheless, these new agents will reduce the burden of anticoagulation management at the patient as well as Health Care level.

Original languageEnglish
Pages (from-to)583-592
Number of pages10
JournalCurrent Treatment Options in Neurology
Volume15
Issue number5
DOIs
Publication statusPublished - Oct 2013

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Keywords

  • Atrial fibrillation
  • Hemorrhagic complications
  • New oral anticoagulants
  • Prevention
  • Stroke
  • Vitamin K antagonists

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Testa, L., Fasano, A., De Sanctis, V., Latini, R. A., Latib, A., Oreglia, J., De Marco, F., Agnifili, M., Casavecchia, M., Talarico, G. P., Lanotte, S., Pizzocri, S., Mattioli, R., Mantica, M., & Bedogni, F. (2013). Selection of medications to prevent stroke among individuals with atrial fibrillation: Update on prevention of stroke in patients with AF. Current Treatment Options in Neurology, 15(5), 583-592. https://doi.org/10.1007/s11940-013-0248-3