Pharmacological treatments for stroke prevention in AF

Atrial fibrillation currently effects over 6 million Europeans, causing 22 500 non-valvular strokes each year, and its prevalence is due to double in the next 50 years. As the burden of atrial fibrillation increases, early detection and stroke prevention with timely thromboprophylaxis is imperative. For six decades, warfarin has been the ‘gold standard’ prophylaxis against stroke in patients with atrial fibrillation, but the advent of novel oral anticoagulants means that warfarin is no longer the only option. Novel oral anticoagulants, such as dabigatran, rivaroxaban and apixaban, are redefining the thromboprophylaxis of atrial fibrillation and are at least as effective as warfarin in stroke risk prevention, with better safety, consistently limiting the number of cases of intracranial haemorrhage. This article reviews the treatment options available for stroke prevention in atrial fibrillation and the implications for patients and those who care for them.