Criteria for the choice of anticoagulant therapy for the prevention of stroke in patients with atrial fibrillation early after the marketing of direct oral anticoagulants in Italy

Published: 2 May 2017
Author(s): I. Marzona, M.C. Roncaglioni, F. Avanzini, M.G. Franzosi, M. Moia, members of an ad hoc study group
Issue: May 2017
Section: Letter to the Editor

Atrial Fibrillation (AF) is the most common arrhythmia which is associated with an enhanced risk of stroke and mortality [1]. Oral anticoagulants (OACs) decrease the risk of thromboembolic stroke by 66% and death by 27% [2]. Direct oral anticoagulant drugs (DOACs) are a new class of drugs proven to be at least as efficacious as vitamin K antagonists (VKAs) in the prevention of thromboembolic events in large randomized controlled trials in patients with non valvular AF (NVAF). Their safety, as measured by the rate of bleeding complications, is not clearly superior to that of VKAs, but the ominous occurrence of intracerebral bleeding is significantly reduced by all DOACs [3].