Prevention of Stroke by Antithrombotic Therapy in Patients with Atrial Fibrillation

Citation : Athanasios J. Manolis, Leonidas E. Poulimenos

Atrial Fibrillation (AF) is the most common clinically significant sustained cardiac arrhythmia, a major risk factor for strokes whether it is symptomatic or silent. The older CHADS₂ score and the newer CHA₂DS₂-VASc are well validated to determine stroke risk and guide initiation of antithrombotic therapy, but haemorrhagic risk has to be respected as well, and scores such as HAS-BLED should be widely used. Old fashioned warfarin became standard of care outperforming antiplatelets in every trial but novel classes of anticoagulants that overcome many of warfarin drawbacks have been introduced and are already guideline recommended regiments. Nevertheless their use poses new questions that have to been answered in the near future.