What is the role of oral anticoagulation in stroke prevention in patients with atrial fibrillation (AF)?

Updated: Dec 18, 2018
  • Author: Salvador Cruz-Flores, MD, MPH, FAHA, FCCM, FAAN, FACP, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Answer

Oral anticoagulation (ie, target INR 2.5, range 2-3) is the therapy of choice for primary and secondary stroke prevention in patients with atrial fibrillation and any of the additional risk factors described above, according to guidelines from the American College of Cardiology, American Heart Association, and European Society of Cardiology. [14]

In a 2014 update of guidelines for stroke prevention by the American Academy of Neurology, the AAN recommended routinely offering anticoagulation to patients with nonvalvular atrial fibrillation and a history of transient ischemic attack or stroke. The American Heart Association and American Stroke Association expanded their list of recommended anticoagulants to include dabigatran, apixaban, and rivaroxaban, as well as warfarin, for patients with nonvalvular atrial fibrillation who are at acceptably low risk for hemorrhagic complications. [22, 23]


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