Underuse of Vitamin K Antagonist and Direct Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation: A Contemporary Review.

Jonathan C Hsu, James V Freeman

Journal: Clinical pharmacology and therapeutics 2019;104(2):301-310

PMID: 29328506

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Abstract

Atrial fibrillation (AF) is a leading cause of stroke. Oral anticoagulant (OAC) therapy can significantly reduce the risk of stroke in patients with AF, but underuse of OACs for stroke prevention continues to be a serious clinical problem, with significant deleterious impact on outcomes. We review the studies demonstrating OAC underutilization and evaluating strategies for promoting the increased use of OAC therapy for stroke prevention in nonvalvular AF (NVAF) patients, including in special patient populations.

Address: University of California San Diego Medical Center, La Jolla, California, USA.; Yale School of Medicine, New Haven, Connecticut, USA.

DOI: 10.1002/cpt.1024

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MeSH Terms: Administration, Oral, Anticoagulants, Atrial Fibrillation, Drug Prescriptions, Health Services Misuse, Humans, Practice Patterns, Physicians', Risk Assessment, Risk Factors, Stroke, Treatment Outcome, Vitamin K