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Practical Management of Stroke Prevention in Patients with Atrial Fibrillation and Renal Impairment Receiving Newer Oral Anticoagulants:Focus on Rivaroxaban

Abstract

Jafna L Cox

Stroke is the most feared risk associated with atrial fibrillation (AF). Both stroke and bleeding risk are independently
increased in patients with AF and renal dysfunction. The newer oral anticoagulants show similar or better stroke
prevention without further bleeding risk compared with vitamin K antagonist therapy and without its numerous
practical challenges. Nonetheless, renal monitoring is an important aspect of newer oral anticoagulant treatment.
This paper reviews management of patients with AF and renal impairment receiving newer oral anticoagulants, with
a specific focus on rivaroxaban given that it is now prescribed more often than warfarin by cardiologists in the US.

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