Prophylaxis of Stroke in Patients with Atrial Fibrillation: The Role of Contemporary Anticoagulants

• Published in: Neuroscience and behavioral physiology Vol. 45; no. 2; pp. 206 - 212
• Main Authors: Anisimova, A. V., Gendlin, G. E., Borisov, S. N.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.02.2015; Springer Nature B.V
• Subjects: Anticoagulants; Behavioral Sciences; Biomedical and Life Sciences; Biomedicine; Blood clots; Cardiac arrhythmia; Cardiovascular disease; Disease prevention; Effectiveness; Heart; Ischemia; Neurobiology; Neurosciences; Stroke; Thrombosis; Russia; primary and secondary prophylaxis; atrial fibrillation; rivaroxaban; oral anticoagulants; cardioembolic stroke; warfarin
• ISSN: 0097-0549; 1573-899X
• DOI: 10.1007/s11055-015-0059-y

This review addresses the question of the primary and secondary prophylaxis of cardioembolic stroke in patients with nonvalvular atrial fibrillation. The indications and regimens for use of anticoagulant therapy are discussed, as are the prophylactic advantages and difficulties in using one of the most widespread oral anticoagulant, warfarin. The mechanism of action, efficacy, and safety of the oral anticoagulant rivaroxaban are compared with those of warfarin. Review of large-scale meta-analyses leads to the conclusion that rivaroxaban is somewhat more effective than warfarin and is no less safe; it is very convenient for use. No laboratory monitoring of hemostasis parameters is required during rivaroxaban treatment. This allows this agent to be recommended for the prophylaxis of cardioembolic stroke in patients with atrial fibrillation.