Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation: a narrative review

Abstract

Background: The use of direct oral anticoagulants (DOACs) for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) has gradually increased since they were introduced in 2011. Today, more patients are treated with DOACs than with warfarin. As a result, the overall number of NVAF patients receiving oral anticoagulants has risen. However, it’s not clear whether this increase has led to a lower rate of stroke.

Main body: This review examines clinical studies from various regions around the world that have investigated the relationship between increased anticoagulant use and the incidence of stroke and systemic embolism. Across the studies reviewed, a higher use of oral anticoagulants in the community was linked to a drop in ischemic stroke rates in patients with NVAF.

Conclusion: These cumulative findings suggest a negative correlation between increased oral anticoagulant use and the rate of ischemic strokes.

Keywords: Direct oral anticoagulants, non-valvular atrial fibrillation, ischemic stroke