Optimal long-term antithrombotic management of atrial fibrillation: life cycle management

R. Pisters, A. Elvan, H. J. G. M. Crijns, M. E. W. Hemels*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Optimal antithrombotic management of atrial fibrillation equals balancing between prevention of arterial thromboembolism, predominantly ischaemic stroke, and haemorrhagic complications. Over time different antithrombotic agents and strategies have been developed. At present, non-vitamin K antagonist oral anticoagulants (NOACs) are the first-line therapy for stroke prevention in patients with non-valvular atrial fibrillation (i.e. without a mechanical valve prosthesis or rheumatic heart disease). Considering the impact of the suboptimal adoption of recommended oral anticoagulant therapy, as experienced with the previous first-line vitamin K antagonists, this review focuses on adequate use of NOACs. As such, we address the most important and clinically challenging issues in the antithrombotic life cycle management for long-term stroke prevention in atrial fibrillation.
Original languageEnglish
Pages (from-to)311-320
Number of pages10
JournalNetherlands Heart Journal
Volume26
Issue number6
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Atrial fibrillation
  • Anticoagulation
  • Stroke risk
  • Bleeding risk
  • NOAC
  • VKA
  • RANDOMIZED CONTROLLED-TRIAL
  • BLEEDING RISK
  • STROKE PREVENTION
  • ORAL ANTICOAGULATION
  • NATIONWIDE COHORT
  • ELDERLY-PATIENTS
  • GASTROINTESTINAL HEMORRHAGE
  • INTRACEREBRAL HEMORRHAGE
  • WARFARIN THERAPY
  • GENERAL-PRACTICE

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