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

doi:10.1002/cpt.1024

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

Clin Pharmacol Ther. 2018 Aug;104(2):301-310. doi: 10.1002/cpt.1024. Epub 2018 Feb 13.

Authors

Jonathan C Hsu¹, James V Freeman²

Affiliations

¹ University of California San Diego Medical Center, La Jolla, California, USA.
² Yale School of Medicine, New Haven, Connecticut, USA.

PMID: 29328506
DOI: 10.1002/cpt.1024

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.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Administration, Oral
Anticoagulants / administration & dosage*
Anticoagulants / adverse effects
Atrial Fibrillation / diagnosis
Atrial Fibrillation / drug therapy*
Atrial Fibrillation / epidemiology
Drug Prescriptions
Health Services Misuse / trends*
Humans
Practice Patterns, Physicians' / trends*
Risk Assessment
Risk Factors
Stroke / diagnosis
Stroke / epidemiology
Stroke / prevention & control*
Treatment Outcome
Vitamin K / antagonists & inhibitors*

Substances

Anticoagulants
Vitamin K