Atrial fibrilasi diketahui dapat meningkatkan risiko stroke, sehingga pencegahan stroke dengan pemberian warfarin atau antikoagulan oral baru umum dilakukan kepada pasien yang mengalami atrial fibrilasi. Contoh antikoagulan oral baru yang dimaksud adalah rivaroxaban, apixaban, edoxaban, dan betrixaban.
Atrial fibrilasi meningkatkan risiko stroke trombosis hingga 4–5 kali lipat. Diperkirakan, sekitar 17–30% kejadian stroke trombosis berhubungan dengan atrial fibrilasi. Pada pasien atrial fibrilasi, terjadi stasis darah, hipokontraktilitas atrial, remodelling struktur atrial, serta aktivasi platelet dan kaskade koagulasi. Kondisi-kondisi ini meningkatkan risiko terbentuknya trombus dan terjadinya stroke iskemik.[1]
Berbagai guideline menyarankan penggunaan antikoagulan oral pada pasien atrial fibrilasi untuk mencegah stroke trombosis. Warfarin merupakan jenis antikoagulan oral yang paling lama dan paling sering dipakai. Namun, warfarin memiliki risiko perdarahan yang tinggi dan menyebabkan luaran ginjal kurang baik. Oleh karena itu, antikoagulan oral baru terkadang digunakan sebagai alternatif warfarin.[2,3]
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Referensi
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3. Coleman CI, et al. Rivaroxaban's Impact on Renal Decline in Patients With Nonvalvular Atrial Fibrillation: A US MarketScan Claims Database Analysis. Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619868535. doi: 10.1177/1076029619868535
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