Stroke Prevention with Anticoagulant in Cardiovascular Problem: Focus in Atrial Fibrillation

DOI

10.2991/978-94-6463-048-0_32How to use a DOI?

Keywords

Stroke Prevention; Anticoagulant; Cardiovascular Problem; Atrial Fibrillation

Abstract

Cardiovascular problems such as atrial fibrillation is a serious and growing health problem in the global community. The presence of atrial fibrillation increases the risk of stroke, which in turn has its own problems and impact. Data have shown that the use of warfarin reduces the risk of stroke in patients with atrial fibrillation, yet this drug has been historically underutilized due to challenges with its use.

New oral anticoagulants (NOACs) are easier to use, have a lower risk of major bleeding, and have been shown to be non-inferior, and in some cases, superior to warfarin. NOACs have started to replace warfarin as the first choice anticoagulant in clinical practice. Optimal strategies to reduce stroke and risk of major bleeding in subsets of atrial fibrillation patients undergoing Percutaneous Coronary Intervention (PCI) and ablation will continue to evolve. When evaluating patients with AF, care should be taken to address the risk of stroke and provide recommendations on the use of anticoagulation to reduce it.

As atrial fibrillation becomes the most prevalent arrhythmia that is associated with an increased risk of ischemic stroke, stroke prevention is crucial for management of atrial fibrillation patients. The NOACs, such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing ischemic stroke with a lower rate of major bleeding. This review article provides evidence on the performance of NOACs in AF patients with different clinical conditions. Despite the evidence from recent trials, further research is necessary for patients undergoing PCI, bioprosthetic valve replacement, transcatheter aortic valve intervention, mitraclip and for those requiring long-term antiplatelet therapy over anticoagulation.

Copyright

© 2023 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Ismail Setyopranoto
AU  - Punik Mumpuni Wijayanti
AU  - Utami
PY  - 2022
DA  - 2022/12/19
TI  - Stroke Prevention with Anticoagulant in Cardiovascular Problem: Focus in Atrial Fibrillation
BT  - Proceedings of the 3rd International Conference on Cardiovascular Diseases (ICCvD 2021)
PB  - Atlantis Press
SP  - 269
EP  - 292
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6463-048-0_32
DO  - 10.2991/978-94-6463-048-0_32
ID  - Setyopranoto2022
ER  -