Anticoagulation in Atrial Fibrillation Patients

Abstract

Atrial fibrillation (AF) is the most common arrhythmia and may cause thromboembolic events, typically stroke. Advances in pharmacological approaches to anticoagulation and groundbreaking large randomized controlled trials of non-vitamin K antagonist oral anticoagulants (NOACs) have changed the paradigm of anticoagulation therapy. Furthermore, observational studies support the efficacy and safety of NOAC. Few studies address the differences among NOACs, but prescriptions should be based on a thorough understanding of their pharmacological differences, including interactions, side effects, reversibility, and practical approach. In a subset of patients with AF, warfarin may still be the preferable option. Consequently, an individualized approach to oral anticoagulation is crucial.

Updates on epicardial adipose tissue mechanisms on atrial fibrillation

“…Vitamin K antagonists (VKAs) (i.e., warfarin) are commonly administered to patients with AF, and are still considered to be the safest for patients with specific characteristics, including rheumatic mitral valve disease or artificial heart valve 11 . Non‐vitamin K antagonist oral anticoagulants, such as dabigatran, edoxaban, rivaroxaban, or apixaban, have demonstrated efficacy and should be implemented (in preferred cases) because, among other advantages, they do not require frequent monitoring like VKAs 129 . Other therapies include antiplatelet agents, factor Xa inhibitors, and direct thrombin inhibitors or combinations (i.e., aspirin and clopidogrel).…”