Atrial fibrillation is the most common arrhythmia and accounts for one-third of hospitalizations for rhythm disorders in theUnited\nStates. The prevalence of atrial fibrillation averages 1% and increases with age. With the aging of the population, the number of\npatients with atrial fibrillation is expected to increase 150% by 2050, withmore than 50% of atrial fibrillation patients being over the\nage of 80. This increasing burden of atrial fibrillation will lead to a higher incidence of stroke, as patients with atrial fibrillation have\na five- to sevenfold greater risk of stroke than the general population. Strokes secondary to atrial fibrillation have a worse prognosis\nthan in patients without atrial fibrillation.Vitamin Kantagonists (e.g., warfarin), direct thrombin inhibitors (dabigatran), and factor\nXa inhibitors (rivaroxaban and apixaban) are all oral anticoagulants that have been FDA approved for the prevention of stroke in\natrial fibrillation. This review will summarize the experience of anticoagulants in patients with atrial fibrillation with a focus on the\nexperience at the Duke Clinic Research Institute.
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