Atrial Fibrillation and Stroke: Making Sense of Recent Observations on Anticoagulation

Atrial fibrillation (AF) is the most prevalent heart rhythm disorder. AF accounts for a great proportion of deaths because it independently increases all-cause mortality and cardiovascular mortality risks. Ischemic stroke is the most common cardiovascular adverse event in AF patients. Oral anticoagulation (OAC) therapy with vitamin K antagonists (VKA) has been central for stroke prevention. Several drugs with a direct inhibitory effects on thrombin and factor Xa have been developed. These non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safer than warfarin. This review provides an overview of current guidelines and summarizes current evidence for the prevention of stroke in AF patients according to most relevant patients' subgroups and clinical features.