Abstract
Background: Nonvalvular atrial fibrillation (NVAF) needs more carefully address, with special caution to the risk of ischemic stroke, which is the most serious complication. The first line of defense against NVAF related stroke is an anticoagulant. Anticoagulants have been used frequently for years to prevent and treat this potentially deadly blood clot. However, widely used traditional therapies are associated with significant limitations.

Objective: Assessment and evaluation of current stroke prevention strategies and investigate whether the current used oral anticoagulant drugs have a major impact on stroke prevention in NVAF Sudanese patients.

Materials and Methods: This was observational retrospective cohort study design, including 200 patients with diagnosed NVAF. The study was conducted in different Khartoum Cardiac centers. Patients with NVAF seen between 2013 and 2015 were identified in a database and followed up for mortality, stroke, and bleeding events. They were divided into two groups, 150 patient taking warfarin and 50 were on dabigatran (Pradaxa). This study included two patients’ data collection forms which were prepared using specific measure tools of stroke and bleeding risk factors, CHA2DS2VASC score and [HAS-BLED] bleeding risk score, respectively. Patients with CHA2DS2VASC score <2 were excluded.

Results: Among 150 NVAF patients taking warfarin, 48% of patients had stroke, 28% of patients had bleeding, and 2% passed away. Patients on 150 mg of dabigatran no stroke event or bleeding case were recorded.

Conclusions: This study demonstrates that dabigatran is better than warfarin for NVAF Sudanese patients as an anticoagulation agent to prevent AF related stroke. It is associated with a decreased bleeding events and no significant increase in embolic events. Furthermore, it seems to have similar stroke prevention effect as well as warfarin.

Key words: Antithrombotic Drugs; Atrial Fibrillation; Warfarin, Arrhythmia; Pradaxa