Non-vitamin K antagonist oral anticoagulants (NOACs) offer improved efficacy and safety, particularly by reducing intracranial hemorrhage, compared to vitamin K antagonists for stroke prevention in Asian patients with atrial fibrillation.
Do NOACs improve stroke prevention and reduce bleeding risk compared to VKAs in Asian patients with atrial fibrillation?
NOACs are preferred over VKAs for stroke prevention in Asian patients with atrial fibrillation due to their superior efficacy and safety profile, particularly regarding the reduction of intracranial hemorrhage.
Atrial fibrillation (AF) is the most common arrhythmia conferring a fivefold increased risk of stroke. Stroke prevention is the cornerstone of management of patients with AF. Asians have a generally higher incidence of AF-related risks of stroke and bleeding (particularly intracranial bleeding), compared with non-Asians. Despite the well-documented efficacy and relative safety of oral anticoagulation for stroke prevention among Asians, the suboptimal use of oral anticoagulation remains common. The current narrative review aims to provide a summary of the available evidence on stroke prevention among patients with AF focused on the Asia region, regarding stroke and bleeding risk evaluation, the performance of oral anticoagulation, and current use of thromboprophylaxis.
Li et al. (Mon,) conducted a review in Atrial fibrillation. Oral anticoagulation (NOACs and VKAs) vs. No treatment or Aspirin was evaluated. Non-vitamin K antagonist oral anticoagulants (NOACs) offer improved efficacy and safety, particularly by reducing intracranial hemorrhage, compared to vitamin K antagonists for stroke prevention in Asian patients with atrial fibrillation.