Review  |   December 2017
Role of Antiplatelet Therapy in Stroke Prevention in Patients With Atrial Fibrillation
Author Notes
  • From the Internal Medicine Residency Program at the University of Connecticut in Farmington (Dr Manaktala) and the Department of Cardiology at Hartford Hospital in Connecticut (Dr Kluger). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Rohini Manaktala, DO, Resident Physician in Training, University of Connecticut Health Center, Internal Medicine Department/Residency Program, 263 Farmington Ave, Farmington, CT 06030-1956. E-mail: manaktala@uchc.edu
     
Article Information
Cardiovascular Disorders / Preventive Medicine
Review   |   December 2017
Role of Antiplatelet Therapy in Stroke Prevention in Patients With Atrial Fibrillation
The Journal of the American Osteopathic Association, December 2017, Vol. 117, 761-771. doi:10.7556/jaoa.2017.148
The Journal of the American Osteopathic Association, December 2017, Vol. 117, 761-771. doi:10.7556/jaoa.2017.148
Abstract

Patients with atrial fibrillation are at increased risk of having a cardioembolic stroke. The use of oral anticoagulation is now well established to prevent strokes in patients with atrial fibrillation and a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [2 points], diabetes mellitus, prior stroke/transient ischemic attack or thromboembolism [2 points], vascular disease, age 65 to 74 years, and sex category) score of greater than 1, beyond sex. However, the role of antiplatelet therapy, specifically aspirin in low-risk patients or as an alternative to oral anticoagulation, remains controversial. The most recent US guidelines conflict with the European guidelines, which do not recommend antiplatelet monotherapy for stroke prevention irrespective of stroke risk. The aim of this review is to summarize published studies that question the role of aspirin in preventing strokes associated with atrial fibrillation. Overall, aspirin is found to play a limited role in the prevention of stroke in patients with atrial fibrillation and is associated with a similar risk of hemorrhagic events compared with anticoagulants. The benefit of dual antiplatelet therapy as an alternative to oral anticoagulation requires further study.

Subscribe to view more

For full access to this article, log in to an existing user account, purchase an annual subscription, or purchase a short-term subscription.

Order a subscription

Subscribe

Pay Per View

Entire Journal
30-Day Access

$30.00

Buy Now

This Issue
7-Day Access

$15.00

Buy Now

This article
24-Hour Access

$5.00

Buy Now

Sign In Or Create an account

Please sign in using your Osteopathic.org login.
If you do not have an AOA login, you may create a new account.

Or Subscribe