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Prevention of Stroke in Patients with High-Risk Atrial Fibrillation

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Abstract

Atrial fibrillation (AF) causes nearly 10% of all ischemic strokes. Long-term oral anticoagulation with warfarin currently is the best treatment for preventing stroke in patients with AF and other stroke risk factors. However, many eligible patients do not receive warfarin, and some patients with AF are unsuitable for this treatment. Recent clinical trials have tested alternatives to long-term warfarin, and some new treatment options have emerged. Nonpharmacologic approaches to stroke prevention in atrial fibrillation also are under development. In addition, new diagnostic modalities may detect paroxysmal AF with more sensitivity, potentially expanding the population to be treated and the potential impact of stroke preventive strategies on the population. This review provides a practical guide to current treatment and diagnostic options.

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Disclosure

Dr. Bernstein serves as a consultant and speaker for Sanofi-Aventis, Medtronic, Bristol-Myers Squibb, and Boehringer-Ingelheim. He was an unpaid co-investigator in the RE-LY trial and receives compensation for work on the steering committee of CRYSTAL-AF and salary support as a principal investigator for the ARISTOTLE trial. Dr. Passman serves as a speaker for GlaxoSmithKline, Medtronic, and St. Jude and receives compensation for work on the steering committee of the CRYSTAL-AF study.

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Authors and Affiliations

  1. Davee Department of Neurology, Stroke Program, Feinberg School of Medicine of Northwestern University, 710 North Lake Shore Drive, Abbott Hall, 11th Floor, Chicago, IL, 60611, USA

    Richard A. Bernstein & Rod Passman

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  1. Richard A. Bernstein
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  2. Rod Passman
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Correspondence to Richard A. Bernstein.

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Bernstein, R.A., Passman, R. Prevention of Stroke in Patients with High-Risk Atrial Fibrillation. Curr Neurol Neurosci Rep 10, 34–39 (2010). https://doi.org/10.1007/s11910-009-0085-7

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