Summary

Atrial fibrillation (AF) is a worldwide public health problem, with a prevalence of 10% to 15% after 80 years of age. The morbidity and mortality secondary to AF is high. With regard to the outcomes of stroke, the attributable risk of AF increases sharply from 1.5% to 23.5% for ages 50 to 59 years and 80 to 89 years, respectively. AF-related stroke is particularly concerning as it carries a high mortality, with 1 in 4 patients dying within 30 days. This article discusses stroke prevention in elderly patients with AF, including data on the advances in pharmacological therapeutic and agent selection that are used to balance thromboembolic risk with bleeding risk in patients with AF.