Novel Anticoagulants in Prevention of Cardioembolic Stroke in Patiens with Non-Valvular Atrial Fibrillation

Anticoagulant therapy plays an important role in primary and secondary prevention of brain embolism in patients with non-valvular atrial fibrillation. Warfarin is the most commonly used anticoagulant in these indications. Warfarin significantly reduces the risk of stroke and death but increases the risk of bleeding. Life-threatening intracerebral haemorrhage is the most serious complication of anticoagulant therapy, with a mortality potentially exceeding 50%. Direct thrombin inhibitor (dabigatran) and factor Xa inhibitors (rivaroxaban, apixaban) present promising alternatives to warfarin. This new anticoagulant therapy is as, or more, effective than warfarin and has demonstrated significantly better safety profile. In many patients, this therapy rightfully replaces warfarin.