Minimizing The Risk Of Hemorrhagic Stroke During Oral Anticoagulant Therapy For Atrial Fibrillation: The Neurologist’s Perspective

Author:Bo Norrving, Roland Veltkamp
Volume Info:Volume 1 Issue 1
Article Information

Volume 1 Issue 1 , pages 1-5
Published May 2015


Department of Clinical Neuroscience, Lund University Hospital, Lund, Sweden


Professor of Neurology, Chair of Stroke Medicine, Imperial College London


Corresponding Author:


Until recently, warfarin has been the gold standard for reducing stroke risk and mortality in patients with atrial
fibrillation (AF). The key goals of antithrombotic treatment are the primary and secondary prevention of ischemic
stroke and systemic embolism while minimizing the risk of major bleeds. While highly effective, warfarin has several limitations that have led to well-documented underutilization and suboptimal care by both physicians and patients. Recently, two classes of novel oral anticoagulants (NOACs) have emerged that may overcome some of the clinical challenges associated with warfarin use: the oral direct thrombin inhibitors (dabigatran) and the oral direct factor Xa inhibitors (rivaroxaban, apixaban). Most recently, the US Food and Drug Administration approved edoxaban in January 2015 and a European Medicines Agency approval application was filed for edoxaban in 2014) [1]. As clinical experience and outcomes research continue to accumulate for NOACs, practical approaches for their clinical use and optimizing patient outcomes continue to evolve.


Acknowledgements: The publication of this article was supported by Daiichi Sankyo, Inc. The views and opinions expressed are those of the authors and not necessarily those of Daiichi Sankyo, Inc.


atrial fibrillation, hemorrhagic stroke, anticoagulant therapy, NOAC, oral direct thrombin inhibitors, oral direct Xa inhibitors



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