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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

      Atrial Fibrillation (AF) is the most common arrhythmia which is associated with an enhanced risk of stroke and mortality [
      • Heeringa J.
      • van der Kuip D.A.M.
      • Hofman A.
      • Kors J.A.
      • van Herpen G.
      • Stricker B.H.C.
      • et al.
      Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study.
      ]. Oral anticoagulants (OACs) decrease the risk of thromboembolic stroke by 66% and death by 27% [
      • Hart R.G.
      • Pearce L.A.
      • Aguilar M.I.
      Meta-analysis: antithrombotic therapy to prevent stroke in patients who have non valvular atrial fibrillarion.
      ]. 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 [
      • Verheugt F.W.A.
      • Granger C.B.
      Oral anticoagulants for stroke prevention in atrial fibrillation: current status, special situations, and unmet needs.
      ].

      Keywords

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