In today days Atrial Fibrillation (AF) is the most common cardiac dysrhythmia that is often seen in clinical practice. There are 700,000 strokes in the USA each year and 15% of it caused by Atrial Fibrillation. For a long period of time warfarin was the only oral anticoagulant available in the US for patients with atrial fibrillation to prevent stroke events. Recently a new oral anticoagulants, including apixaban, dabigatran, and rivaroxaban have been developed and became available in the US for the stoke prevention and systemic embolism for patients with atrial fibrillation. Now, when all three new anticoagulants are available as an alternative to warfarin for the same indication, they make the health care providers question which agent is the best and for which patients. New agents have practical advantages over warfarin that has many limitations such as need for monitoring, regular dose adjustment, food and drug interaction and side effects.
