Title:Antithrombotic Options for Atrial Fibrillation in 2012
Volume: 12
Issue: 1
Author(s): Jennifer Rude, Karla Quevedo, Lissette Rodriguez de Armas and Debabrata Mukherjee
Affiliation:
Keywords:
Atrial fibrillation, Antithrombotic, Bleeding, Thromboembolism, Stroke, Clotting factors, embolism, antagonists, intracranial hemorrhage
Abstract: Atrial fibrillation (AF) is a common arrhythmia in clinical practice. An important component of the
management of patients with AF involves prevention of thromboembolism and stroke. Coumarins, such as warfarin had
been the only available oral antithrombotic agent for prevention of thromboembolism for many decades. Following
intestinal absorption, coumarins inhibit multiple steps of the clotting cascade that leads to inhibition of coagulation factors
II, VII, IX and X. In addition to delayed and variable inhibition of coagulation, coumarin therapy has a narrow therapeutic
window for optimal balance of risk and benefit, which requires regular assessment of the international normalized ratio
(INR) to monitor coagulation. A quest for safer, more effective therapies that do not need monitoring has led to the
development of dabigatran, rivaroxaban, and apixaban. In this article, we review these newer antithrombotic agents and
discuss role of these drugs in clinical practice.
