Indications for and implementation of anticoagulant therapy in atrial fibrillation – Related resources
03.06.2016 • Sonuncu dəyişiklik 27.11.2013
This article is created and updated by the EBMG Editorial Team
Cochrane reviews
- Factor Xa inhibitors are marginally more effective in the prevention of strokes and systemic embolic events than treatment with dose-adjusted warfarin in patients with atrial fibrillation, and they appear to reduce the number of all-cause deaths .
- Oral anticoagulants reduce the risk of stroke (ischaemic and haemorrhagic combined) for patients with non-valvular atrial fibrillation and with no prior stroke or TIA by about one third when compared with antiplatelet therapy .
- Adjusted-dose warfarin (INR 2–3) reduces all strokes in patients with nonvalvular atrial fibrillation. For primary prevention in AF patients with an average stroke rate of 4%/year, about 25 strokes and about 12 disabling strokes would be prevented for every 1000 given oral anticoagulation .
Warfarin treatment has a beneficial effect on incidence of fatal or major stroke, but the safety margin is small because of fatal and major bleeds associated with warfarin therapy .
Clinical guidelines
- Heidbuchel H, Verhamme P, Alings M et al. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34(27):2094-106.
- Heidbuchel H, Verhamme P, Alings M et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15(5):625-51.
- Camm AJ, Lip GY, De Caterina R et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012;33(21):2719-47.
- European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm AJ et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31(19):2369-429.
- Fuster V, Rydén LE, Cannom DS et al. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2011;123(10):e269-367.
Literature
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Fuster V, Rydén LE, Cannom DS et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines, European Society of Cardiology Committee for Practice Guidelines, European Heart Rhythm Association, Heart Rhythm Society. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines
(Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 2006 Aug 15;114(7):e257-354.
- Furie KL, Goldstein LB, Albers GW et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: a science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012;43(12):3442-53.
- Lip GY, Andreotti F, Fauchier L et al. Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis. Thromb Haemost 2011;106(6):997-1011.
- Lip GY, Tse HF. Management of atrial fibrillation. Lancet 2007 Aug 18;370(9587):604-18.