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Stroke prevention in atrial fibrillation--pharmacologic strategies.

Stroke prevention in atrial fibrillation presents a challenge for many clinicians. A considerable amount of research has gone into creating scoring systems that can accurately predict thromboembolic risk. Patients at low enough risk are best treated with aspirin, whereas higher-risk patients require anticoagulation with warfarin despite its shortcomings. Antithrombotic regimens for moderate-risk patients require careful consideration based on bleeding risk, age, and the ability to undergo frequent serum monitoring. Oral drugs may soon be available to replace warfarin. While this may simplify dosing and monitoring, it will still be necessary to weigh the risks and benefits of therapy.