When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics

Jaap Seelig, Ron Pisters, Martin E. Hemels*, Menno V. Huisman, Hugo ten Cate, Marco Alings

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach. To guide clinical decision-making, we have reviewed available evidence on the most frequently reported reasons for withholding anticoagulation: previous bleeding, frailty and age, and an overall high bleeding risk.

Original languageEnglish
Pages (from-to)399-408
Number of pages10
JournalVascular health and risk management
Volume15
DOIs
Publication statusPublished - 2019

Keywords

  • hemorrhage
  • frail elderly
  • age
  • anticoagulants
  • atrial fibrillation
  • INTRACRANIAL HEMORRHAGE
  • BLEEDING RISK
  • ANTITHROMBOTIC THERAPY
  • PREDICTING STROKE
  • ELDERLY-PATIENTS
  • WARFARIN
  • OUTCOMES
  • DABIGATRAN
  • SCORE
  • ASSOCIATION

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