Antithrombotic Therapy


Oral anticoagulation, currently most often done with vitamin K antagonist such as warfarin, is a potent therapy to prevent cardio-embolic strokes in atrial fibrillation, and is indicated for most patients with atrial fibrillation. Indeed, vitamin K antagonist therapy reduces stroke risk in patients with AF when appropriately used and properly monitored. However, anticoagulant therapy can also have serious side effects such as severe haemorrhage (bleeding). Other drawbacks include a lack of predictability and drug and food interactions so patients are required to make many lifestyle changes and regular follow-up visits. Two new types of fix-dose oral anticoagulants, direct thrombin inhibitors and direct factor Xa inhibitors, have recently become available in Europe for stroke prevention in AF. These medications are slightly more potent and slightly safer than vitamin K antagonists, and require less monitoring than the vitamin K antagonists. Despite their recent introduction into clinical practice, oral anticoagulation is still under-used in Europe and world-wide.

There is a need for improved education among patients and health professionals on the risks and benefits of oral anticoagulation in atrial fibrillation and on the optimum management of patients receiving it.