Stroke Prevention in atrial Fibrillation: update with NOAC Treatment and the impact of Reversal

Volume 4 Issue 2
Article Information

Abstract

Results from RCTs and real-world analyses consistently demonstrate the safety and efficacy profiles of dabigatran in patients with atrial fibrillation. However, underdosing and under-prescribing of anticoagulants may leave patients at risk of stroke; both doses of dabigatran were fully tested and shown to be effective in stroke prevention. Although side effects of novel oral anticoagulants appear to be improved over vitamin K antagonists (VKA), there may be occasions where the therapeutic effect of the anticoagulant needs to be reversed, for instance, before an urgent surgical procedure. Idarucizumab has been established as an effective reversal agent for dabigatran-treated patients and can be administered promptly and safely in a mobile, pre-hospital setting.

Key words: anticoagulant; stroke; therapeutic reversal; dabigatran; idarucizumab; warfarin

Acknowledgements: We thank the following faculty for their valuable contributions to the symposium:
R Bernstein, Northwestern Medicine Distinguished Physician in Vascular Neurology; Medical Director of Telehealth;Professor of Neurology, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.

T Steiner, Professor of Neurology and Neurointensive Care, and Director of Department of Neurology, Klinikum Frankfurt Hochst; Affiliated Professor, Heidelberg University Hospital, Germany; Honorary Professor, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Acknowledgement of thanks is also extended to Oruen Ltd., for editorial assistance and to Dr Juliane Meyerhoff for support with medical writing in the preparation of this manuscript.