Antithrombotic Therapy for Patients with Atrial Fibrillation and Atherothrombotic Vascular Disease: Striking the Right Balance between Efficacy and Safety.
Circulation. 2013 Jul 16;
Authors: Patrono C, Andreotti F
Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is estimated to affect 1.5 to 2.0% of the general population, i.e., at least 100 million people worldwide.(1) Left untreated, patients with nonvalvular AF (NVAF) are exposed to an annual risk of thromboembolic stroke of approximately 5%, resulting in 5 million AF-related strokes each year.(1) Properly dosed anticoagulation (e.g., warfarin adjusted to an international normalized ratio [INR] of 2.0 to 3.0) is extremely effective in preventing AF-related strokes, reducing risk by two-thirds compared with no therapy, and by one-half compared to aspirin.(1) In contrast, aspirin alone achieves a 21% relative reduction in risk of nonfatal stroke compared with no treatment, and aspirin plus clopidogrel yields an additional 11% reduction compared to aspirin alone.(1) Thus, anticoagulation is the unchallenged current treatment of choice for patients with NVAF at moderate to high risk of thromboembolic complications.
PMID: 23861513 [PubMed - as supplied by publisher]