Anticoagulation in atrial fibrillation: new therapeutic alternatives
Aranda, J.M.
Boletin de la Asociacion Medica de Puerto Rico 104(4): 64-65
2012
ISSN/ISBN: 0004-4849 PMID: 23763229 Document Number: 658413
The fundamental treatment of atrial fibrillation is based on maintenance of sinus rhythm or control of ventricular rate and preventing arterial thromboembolism. Warfarin has been the anti-thrombotic agent of choice for the last 50 years. However multiple interactions with other drugs and certain types of food and vegetables with high Vitamin K content complicate its use. It also requires multiple blood tests to adjust the dose in order to reach adequate and stable anticoagulation. Three new, di-fferent anti thrombotic agents are described. They are as or more effective than Warfarin with decreased incidence of hemorrhagic events. Dabigratan is a direct antithrombotic inhibitor, Rivaroxaban and Apixaban inhibits factor Xa. Their use will probably depend on their cost effectiveness in the population at risk for thromboembolic events.