An Updated Review of Target-Specific Oral Anticoagulants Used in Stroke Prevention in Atrial Fibrillation, Venous Thromboembolic Disease, and Acute Coronary Syndromes

A trial fibrillation (AF) is a common arrhythmia in the adultpopulation. It is associated with up to a 5-fold increased risk of stroke and contributes to a higher morbidity and mortality compared with non–AF-related strokes.1 The current prevalence of AF in the adult population, estimated at 1 % to 2%, is expected to increase by up to 5 times by 2050, which will in turn increase the overall burden of ischemic stroke in the aging population.2,3 Various stroke risk stratification schemes have been developed to quantify stroke risk in patients with AF and guide preventive treatment decisions for the clinician. The most widely used has been the CHADS2 score, which estimates risk based on the presence of congestive heart failure, hypertension, age 75 years or greater, diabetes mellitus, and prior stroke or transient ischemic attack (TIA).4 A revision of the CHADS2 scheme has been developed fo