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- W2515218139 abstract "Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and occurs in 1-2% of the general population. This arrhythmia is the greatest risk factor of cardiogenic embolism that has poor prognosis. Therefore anticoagulation medication is widely used for stroke prevention in atrial fibrillation (SPAF).Warfarin (WF), which is the only oral anticoagulant, has been used for more than half a century as a SPAF medication. As meta-analysis showed that WF reduced strokes in AF patients by 64%, WF has been highly recommended for stroke prevention in moderate- to high-risk AF patients.However WF is reported to be under-used. The reasons are significant management challenges including the necessities for frequent monitoring of the international normalized ratio (INR) and dose adjustment to maintain the INR within a narrow therapeutic window (2 to 3 for most indications).Today, not only in Japan but also in other regions, a new oral anticoagulant (NOAC) dabigatran, which is a thrombin inhibitor, has been approved as the first NOAC with an indication of SPAF, and an FXa inhibitor with AF indication will be marketed in the near future. Anticoagulant therapy using NOACs for SPAF is in the spotlight around the world since the RE-LY (dabigatran) and ROCKET (rivaroxaban) studies were published and substantiated either superiority or equality in efficacy and safety versus WF.In this paper, the past and current status of anticoagulant therapy in patients with atrial fibrillation will be described. Important points to note when using the new anticoagulants will also be discussed." @default.
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- W2515218139 date "2011-01-01" @default.
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- W2515218139 doi "https://doi.org/10.3999/jscpt.42.315" @default.
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