Novel anticoagulants for stroke prevention in atrial fibrillation among diabetics

Atrial fibrillation is associated with an increased risk of ischaemic stroke and systemic embolism which is further increased in the presence of diabetes. The new CHA 2 DS 2 VASc Risk stratification score is recommended to differentiate truly low-risk patients from intermediate and high stroke-risk patients for who oral anticoagulation would be beneficial. Alongside traditional vitamin K antagonists and aspirin, a number of novel anticoagulants, which do not require anticoagulation monitoring, have emerged in recent years. In this review we discuss the evidence for the clinical benefit and safety of the novel anticoagulants versus warfarin and aspirin among patients with atrial fibrillation and their potential role in the diabetic sub-group population of the clinical trials.