Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 2
File(s)Deiner et al 2015 OA AF Part 2.docx (306.11 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In addition, we discuss the timing of initiation of anticoagulation. In the second of a two-part review, we discuss the use of NOAC for stroke prevention in the following subgroups of patients with AF: (vii) secondary stroke prevention in patients after stroke or transient ischaemic attack (TIA), (viii) patients with acute stroke requiring thrombolysis or thrombectomy, (ix) those initiating or restarting OAC treatment after stroke or TIA, (x) those with renal impairment on dialysis, (xi) the elderly, (xii) those at high risk of gastrointestinal bleeding, and (xiii) those with hypertension. In addition, we discuss adherence and compliance. Finally, we present a summary of treatment suggestions. In specific subgroups of patients with AF, evidence supports the use of particular NOACs and/or particular doses of anticoagulant. The appropriate choice of treatment for these subgroups will help to promote optimal clinical outcomes.
Date Issued
2016-02-04
Date Acceptance
2015-11-09
Citation
EUROPEAN HEART JOURNAL, 2016, 38 (12), pp.860-868
ISSN
0195-668X
Publisher
Oxford University Press
Start Page
860
End Page
868
Journal / Book Title
EUROPEAN HEART JOURNAL
Volume
38
Issue
12
Copyright Statement
© 2016 The Author(s). Published on behalf of the European Society of Cardiology. All rights reserved. For permissions please email: journals.permissions@oup.com. This is a pre-copy-editing, author-produced version of an article accepted for publication in European Heart Journal following peer review. The definitive publisher-authenticated version Hans-Christoph Diener, James Aisenberg, Jack Ansell, Dan Atar, Günter Breithardt, John Eikelboom, Michael D. Ezekowitz, Christopher B. Granger, Jonathan L. Halperin, Stefan H. Hohnloser, Elaine M. Hylek, Paulus Kirchhof, Deirdre A. Lane, Freek W.A. Verheugt, Roland Veltkamp, Gregory Y.H. Lip; Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 2. Eur Heart J 2017; 38 (12): 860-868. doi: 10.1093/eurheartj/ehw069 is available online at: https://dx.doi.org/10.1093/eurheartj/ehw069
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000397146200008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Non-valvular atrial fibrillation
Anticoagulation
Stroke prevention
Non-vitamin K oral antagonist
TRANSIENT ISCHEMIC ATTACK
RE-LY TRIAL
HEART RHYTHM ASSOCIATION
RIVAROXABAN VS. WARFARIN
MAJOR BLEEDING EVENTS
VITAMIN-K ANTAGONISM
ROCKET AF
RANDOMIZED EVALUATION
SUBGROUP ANALYSIS
ARISTOTLE TRIAL
Cardiovascular System & Hematology
1102 Cardiovascular Medicine And Haematology
Publication Status
Published