The AFFIRM Study and Its Implications for the Pharmacological Treatment of Atrial Fibrillation

Thromboembolism is the major complication in atrial fibrillation (AF), and its prevention constitutes a major challenge in the modern treatment of this common arrhythmia. The embolic risk is not equal in all subgroups of AF patients but relates to the underlying heart condition: while nonrheumatic AF carries a 5.6-fold embolic risk, arrhythmia of rheumatic origin carries a 17.6-fold risk in comparison with healthy controls. However, nonrheumatic AF is responsible for the larger percentage of strokes (15%-20% of cerebrovascular accidents of ischemic origin). Another important factor affecting the risk of thromboembolism is age: cerebrovascular accidents associated with AF represent 6.7% of the total number of cerebrovascular accidents in the 50- to 59-year-old group and 36.2% in the over 80-year-old group [1, 2].