TITLE

The Increasing Need for Anticoagulant Therapy to Prevent Stroke in Patients With Atrial Fibrillation

AUTHOR(S)
Ezekowitz, Michael D.; Falk, Rodney H.
PUB. DATE
July 2004
SOURCE
Mayo Clinic Proceedings;Jul2004, Vol. 79 Issue 7, p904
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Ischemic stroke, a major complication of atrial fibrillation (AF), is believed to result from atrial thrombus formation caused by ineffective atrial contraction. Oral anticoagulant therapy effectively reduces the risk of ischemic stroke in patients with AF, this therapy is recommended for patients with any frequency or duration of AF and other risk factors for stroke, such as increased age (>75 years), hypertension, prior stroke, left ventricular dysfunction, diabetes, or heart failure. Recently published data comparing rate-control and rhythm-control strategies in AF emphasized the importance of maintaining an international normalized ratio higher than 2.0 during warfarin therapy and the need for continuing anticoagulant therapy to prevent stroke in high-risk-patients, even if the strategy is rhythm control Hemorrhagic complications can be minimized by stringent control of the international normalized ratio (particularly in elderly patients) and appropriate therapy for comorbidities such as hypertension, gastric ulcer, and early-stage cancers. Undertreatment of patients with AF is a continuing problem, particularly in the elderly population. Patients perceived as likely to be non-compliant, such as the functionality impaired, are less likely to receive warfarin therapy. However, stroke prevention with anticoagulants is cost-effective and improves quality of life, despite the challenges of maintaining appropriate anticoagulation with monitoring and warfarin dose titration. New medications in development with more predictable dosing and fewer drug-drug interactions may reduce the complexities of achieving optimal anticoagulation and increase the practicality of long-term anticoagulant therapy for patients with AF at risk of stroke.
ACCESSION #
13838298

 

Related Articles

  • Warfarin vs Clopidogrel Plus Aspirin for Atrial Fibrillation. DiMarco, John P. // Clinical Cardiology Alert;Jan2008, Vol. 27 Issue 1, p4 

    The atrial fibrillation clopidogrel trial with Irbesartan for Prevention of Vascular Events (ACTIVE W) is a noninferiority trial comparing anticoagulation with warfarin to therapy with aspirin plus clopidogrel for stroke prevention in patients with atrial fibrillation. ACTIVE W enrolled 6706...

  • Registrar: MRCGP Exam Update - AF and anticoagulation. Newson, Louise // GP: General Practitioner;1/26/2007, p47 

    The article focuses on anticoagulation therapy for atrial fibrillation (AF). According to the author, AF increases the risk of stroke. The author asserts that the increase in risk of bleeding on taking warfarin is the reason for the reluctance of many patients with non-rheumatic AF to use it....

  • Outcomes of Patients with Lone Atrial Flutter.  // Annals of Internal Medicine;2/17/2004, Vol. 140 Issue 4, pI-55 

    Presents a summary for patients on the occurrence of rare lone atrial flutter and complications that arise from the condition. Review of the Mayo Clinic medical records with those of a comparison group of healthy residents of Rochester, Minnesota; Development of atrial fibrillation in more than...

  • Another Warfarin Replacement on Horizon. Elliott, William T. // Neurology Alert;Jan2011 Phamacology Watch, p1 

    The article discusses the Stroke Prevention Using the Oral Direct Factor Xa Inhibitor Rivaroxaban Compared With Warfarin in Patients with Nonvalvular Atrial Fibrillation (ROCKET AF) study which revealed the efficacy of rivaroxaban as another warfarin replacement for preventing stroke and blood...

  • Clopidogrel-aspirin an option in AF.  // Pulse;4/8/2009, Vol. 69 Issue 12, p3 

    The article reports on the findings of a randomised controlled trial in patients with atrial fibrillation, conducted by researchers in London, England. The study found that combined therapy with clopidogrel and aspirin may reduce the risk of stroke. It also revealed that the combination of...

  • First oral warfarin alternative approved in the US. Hughes, Bethan // Nature Reviews Drug Discovery;Dec2010, Vol. 9 Issue 12, p903 

    The article reports on the approval of the oral anticoagulant dabigatran to be used for stroke prevention in atrial fibrillation (SPAF) by the U.S. Food and Drug Administration. Richard Becker, director of the Cardiovascular Thrombosis Center at Duke School of Medicine in North Carolina, states...

  • Patients With Atrial Fibrillation Often Receive Improper Levels of Warfarin. Mitka, Mike // JAMA: Journal of the American Medical Association;10/8/2008, Vol. 300 Issue 14, p1640 

    The article discusses the treatment of patients suffering from atrial fibrillation, examining a study which found the use of anitcoagulation therapy to be underutilized with regards to preventing ischemic stroke in high-risk patients. The study was paid for by the Canadian Stroke Network and...

  • New Alternative to Warfarin May Help Reduce Stroke Risk in Patients With AF. Mitka, Mike // JAMA: Journal of the American Medical Association;1/5/2011, Vol. 305 Issue 1, p25 

    The article discusses the findings of the Stroke Prevention Using the Oral Direct Factor Xa Inhibitor Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation (ROCKET AF) trial presented during the Scientific Sessions of the American Heart Association (AHA) meeting...

  • Atrial fibrillation: Anticoagulants reduce stroke risk by two thirds.  // Geriatrics;Feb94, Vol. 49 Issue 2, p18 

    Discusses the results of a study on the use of oral anticoagulant therapy to reduce the risk of stroke in patients with nonrheumatic atrial fibrillation. Contraindications of warfarin therapy.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics