Why the study?
Patients with nonvalvular atrial fibrillation frequently have multiple comorbidities and polypharmacy, necessitating effective and safe antithrombotic therapy to protect against cardioembolic stroke and other adverse outcomes.
In comorbid patients with atrial fibrillation, comprehensive management including NOACs like rivaroxaban is crucial for preventing both thromboembolic and coronary events while preserving renal function.
Highlights interconnections in comorbid nonvalvular AF; leaves open optimal protection strategies for prospective trials.
This article focuses on the etiology and pathogenesis of nonvalvular atrial fibrillation in patients with comorbidities such as coronary artery disease, heart failure, type 2 diabetes, and chronic kidney disease. The authors discuss the interconnection of atrial fibrillation and these diseases, and also note the need for protection of such patients (prevention of cardioembolic stroke and other systemic embolism, reduction of coronary risk, improvement of prognosis, slowing the progression of renal dysfunction, increasing medical adherence, etc.) by adequate antithrombotic therapy that does not lose effectiveness and/or safety in presence of multiple diseases and polypharmacy.
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Algiyan et al. (2020) studied this question.
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