Review Article
Jafna L Cox
Abstract
Stroke is the most feared risk associated with atrial fibrillation (AF). Both stroke and bleeding risk are independently increased in patients with AF and renal dysfunction. The newer oral anticoagulants show similar or better stroke prevention without further bleeding risk compared with vitamin K antagonist therapy and without its numerous practical challenges. Nonetheless, renal monitoring is an important aspect of newer oral anticoagulant treatment. This paper reviews management of patients with AF and renal impairment receiving newer oral anticoagulants, with a specific focus on rivaroxaban given that it is now prescribed more often than warfarin by cardiologists in the US.