[Stroke prophylaxis in atrial fibrillation : When, how and for whom?] / Schlaganfallprophylaxe bei Vorhofflimmern : Wann, wie und bei wem?
Herz
; 42(4): 373-379, 2017 Jun.
Article
em De
| MEDLINE
| ID: mdl-28439617
ABSTRACT
In patients suffering from atrial fibrillation (AF), modern antithrombotic therapy and anticoagulation strategies should be individualized based on shared decision making including patient preferences and the absolute and relative risks of stroke and bleeding. Estimation of the individual risk for stroke is still based on the CHA2DS2-VASc score. Based on the most recent guidelines for the management of AF, oral anticoagulation therapy should be considered for men with a CHA2DS2-VASc score ≥1 and women with a score ≥2, balancing the expected stroke reduction, risk of bleeding and patient preference. Both vitamin K antagonists and novel oral anticoagulants (NOAC) are effective for the prevention of stroke in AF. In AF patients treated with NOAC, kidney function should be regularly monitored to refine risk estimation and to enable dose adaptation. As an alternative to oral anticoagulation therapy, left atrial appendage occlusion may be considered for stroke prevention in patients with AF and contraindications for long-term anticoagulant treatment. This article provides a review of the indications and contraindications of modern stroke prophylaxis and discusses the approach to frequent clinical scenarios, such as treatment of patients with an acute coronary syndrome, coronary stent intervention or catheter ablation of AF.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Acidente Vascular Cerebral
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Fibrinolíticos
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Hemorragia
/
Anticoagulantes
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
De
Revista:
Herz
Ano de publicação:
2017
Tipo de documento:
Article