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Selection of Medications to Prevent Stroke Among Individuals With Atrial Fibrillation

Update on Prevention of Stroke in Patients with AF

  • CEREBROVASCULAR DISORDERS (HP ADAMS JR, SECTION EDITOR)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

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.

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Acknowledgments

The authors would like to thank Ms. Giulia D’ Agostino for her irreplaceable support.

Compliance with Ethics Guidelines

Conflict of Interest

L. Testa declares that he has no conflict of interest, A. Fasano declares that he has no conflict of interest, V. De Sanctis declares that he has no conflict of interest, R.A. Latini declares that he has no conflict of interest, A. Latib declares that he has no conflict of interest, J. Oreglia declares that he has no conflict of interest, F. De Marco declares that he has no conflict of interest, M. Agnifili declares that he has no conflict of interest, M. Casavecchia declares that he has no conflict of interest, G. P. Talarico declares that he has no conflict of interest, S. Lanotte declares that she has no conflict of interest, S. Pizzocri declares that he has no conflict of interest, R. Mattioli declares that he has no conflict of interest, M. Mantica declares that he has no conflict of interest, F. Bedogni declares that he has no conflict of interest,

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Cardiology, Istituto Clinico S. Ambrogio, IRCCS San Donato, Milan, Italy

    Luca Testa MD, PhD, Valerio De Sanctis MD, Roberto Adriano Latini MD, Mauro Agnifili MD, Matteo Casavecchia MD, Giovanni Paolo Talarico MD, Stefania Lanotte MD, Samuele Pizzocri MD, Roberto Mattioli MD, Massimo Mantica MD & Francesco Bedogni MD

  2. Division of Neurology, University of Toronto, Toronto, ON, Canada

    Alfonso Fasano MD, PhD

  3. S. Raffaele Hospital, EMO Cuore Columbus, Milan, Italy

    Azeem Latib MD

  4. Niguarda Ca Granda Hospital, Milan, Italy

    Jacopo Oreglia MD & Federico De Marco MD

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  1. Luca Testa MD, PhD
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Correspondence to Luca Testa MD, PhD.

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Testa, L., Fasano, A., De Sanctis, V. et al. Selection of Medications to Prevent Stroke Among Individuals With Atrial Fibrillation. Curr Treat Options Neurol 15, 583–592 (2013). https://doi.org/10.1007/s11940-013-0248-3

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  • DOI: https://doi.org/10.1007/s11940-013-0248-3

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