Prevención del ictus en pacientes con fibrilación auricular. Mejorar la protección enla era de la COVID-19

Abstract

Atrial fibrillation is associated with up to a five-fold increase in the risk of stroke. Cardioembolic stroke is usually more severe than other types of stroke and has higher rates of recurrence and permanent disability. Consequently, reducing the risk of stroke through adequate anticoagulation is one of the main goals of treatment in patients with atrial fibrillation. Vitamin K antagonists have been largely superseded by direct oral anticoagulants because the results of clinical trials, real-life studies and, recently, population studies have all demonstrated that direct oral anticoagulants are more effective (i.e. the risk of stroke and death is lower) and safer (i.e. the risk of intracranial hemorrhage is lower) than vitamin K antagonists. In addition, COVID-19 pandemic, the preferential use of direct oral anticoagulants instead of vitamin K antagonists has been a key strategy for ensuring that the quality of anticoagulation is optimal and that patients are better protected against SARS-CoV-2 infection, as no international normalized ratio control is required.