Cardiology patient page. Patient guide for taking the non-vitamin K antagonist oral anticoagulants for atrial fibrillation.

Abstract

Having atrial fibrillation, an irregular heart rhythm, increases your risk of having a stroke. This irregular beating of the heart affects blood flow in the top chambers of the heart and can cause blood cells to collect and stick together, which increases the risk of a blood clot forming. These blood clots may then be carried in the bloodstream to the brain and, if large enough, can block an artery in the brain, resulting in a stroke. Oral anticoagulant drugs (commonly called blood thinners) are used to help prevent strokes by causing the blood to take longer to clot. Two groups of oral anticoagulant drugs are used, vitamin K antagonists (warfarin/Coumadin) and non–vitamin K antagonist oral anticoagulants (NOACs). This Cardiology Patient Page focuses on NOACs. There are currently 4 NOACs available for healthcare providers to prescribe for patients with atrial fibrillation (see Table 1): dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Lixiana/Savaysa). Each drug is available in 2 doses. Your healthcare provider will explain which is the most appropriate drug and dose for you, and why. View this table: Table 1. How and When to Take the NOAC and Reasons for Dose Reductions You may be eligible for a NOAC if you have atrial fibrillation, plus ≥1 of the following stroke risk factors: heart failure, high blood pressure, age ≥65 years, diabetes mellitus, previous stroke (or ministroke/pin stroke), or vascular disease (blockages in your leg arteries, a heart attack, or both), or if you are a woman. You can calculate your own risk of stroke by completing the questions in Table 2. You should discuss whether you are eligible to receive a NOAC for stroke prevention with your doctor, because these medications may not be suitable for everyone who has atrial fibrillation. View this table: Table 2. Calculating Your Own Risk of Stroke Using the CHA2DS …