Antithrombotic therapy in atrial fibrillation

Atrial fibrillation is a hallmark of aging, affecting 6% of individuals age d 65 years or older. Atrial fibrillation also increases the risk for ischem ic stroke by fivefold. A consistent series of randomized, controlled trials have demonstrated that long-term anticoagulation largely reverses the risk for stroke posed by atrial fibrillation. This article reviews these trials and other studies bearing on the optimal intensity of anticoagulation for atrial fibrillation, the selection of patients with atrial fibrillation for long-term anticoagulation, and the efficacy of aspirin as an alternative s troke-preventive agent.