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Review Papers | Medicine | India | Volume 12 Issue 10, October 2023
Harmonising Anticoagulation Therapy in Atrial Fibrillation: Navigating the Waters of Efficacy and Safety
Bharath Damera | Praneeth Ulavala  | Sagar Bhuyar
Abstract: Atrial fibrillation (AF), the most common cardiac arrhythmia globally, presents a formidable challenge to healthcare providers due to its association with thromboembolic complications. This comprehensive review navigates the dynamic landscape of anticoagulation therapy in AF, with a central focus on achieving the delicate equilibrium between therapeutic efficacy and patient safety. Beginning with a historical perspective, we trace the evolution of anticoagulant options from the introduction of warfarin to the contemporary era of direct oral anticoagulants (DOACs). Current guidelines and recommendations are meticulously examined, providing a solid foundation for understanding the evolving standards of care in AF management. The heart of our analysis lies in an extensive exploration of clinical studies and trials that have contributed to our knowledge of anticoagulation's efficacy and safety profiles. We critically assess the advantages and limitations of both traditional warfarin and DOACs, shedding light on the significance of individualised treatment approaches tailored to patient - specific factors, including age, comorbidities, and preferences. In the discussion section, we dissect the intricate interplay between the benefits and risks of anticoagulation therapy in AF. Stroke and bleeding risks are scrutinised in detail, emphasising the importance of shared decision - making between patients and healthcare providers. Furthermore, we delve into monitoring and management strategies, dissecting the complexities of warfarin therapy's narrow therapeutic window and the evolving landscape of DOAC monitoring. Controversies surrounding anticoagulation therapy, such as its selection in specific patient populations, are explored, guided by an evidence - based approach. In conclusion, this review underscores the pivotal role of individualised treatment plans in optimising outcomes for AF patients. The future scope section highlights opportunities for further research, including risk stratification refinement, novel anticoagulant exploration, and the integration of emerging technologies for enhanced precision in AF management.
Keywords: Atrial Fibrillation, anticoagulation, direct oral anticoagulant, stroke
Edition: Volume 12 Issue 10, October 2023,
Pages: 776 - 778