What anticoagulant is most commonly prescribed for patients with atrial fibrillation at risk for stroke?

Warfarin has long been the standard anticoagulant prescribed for patients with atrial fibrillation who are at risk for stroke, primarily due to its well-documented efficacy in reducing the risk of thromboembolic events. Its mechanism of action involves inhibiting vitamin K-dependent clotting factors, which are crucial in the blood coagulation process.

Patients with atrial fibrillation can form blood clots in the left atrial appendage, and these clots can lead to strokes if they dislodge and travel to the brain. Warfarin’s ability to effectively decrease the formation of these clots has made it a cornerstone in stroke prevention for these patients.

While newer oral anticoagulants, like rivaroxaban, are increasingly used and can offer advantages such as fixed dosing and lack of routine monitoring, warfarin still remains widely prescribed, particularly in certain populations or settings where monitoring is feasible. Aspirin and clopidogrel, while they may reduce the risk of clotting, are generally not as effective as warfarin in the specific context of atrial fibrillation.