[The thromboembolic risk of atrial fibrillation].
The assessment of the thrombo-embolic risk is currently well defined in case of atrial fibrillation, in the general population as well as in several subgroups. Predictive factors of thrombo-embolism have been identified, they are clinical and echocardiographic criteria. They allow to stratify the individual risk of each patient and to establish the therapeutic attitude best suited to its thrombo-embolic and haemorrhagic risk profile. Recent clinical trials have demonstrated that oral anticoagulation with coumarinics, adjusted at an INR between 2 and 3, provided a greater protection for patients at higher risk, compared to aspirin, with an acceptable low rate of haemorrhagic complications. When atrial fibrillation is of recent onset, the therapeutic attitude will take into account the time delay between onset of the arrhythmia and the medical consultation, 48 h representing the maximal delay allowed to perform cardioversion without prolonged anticoagulation.
Vandenbossche
J L
JL
Service de Cardiologie, C.H.U. Saint-Pierre, U.L.B.
D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D003374:Coumarins / Q000627:therapeutic use; D004452:Echocardiography; D004554:Electric Countershock; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D019934:International Normalized Ratio; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology*
D000925:Anticoagulants; D003374:Coumarins; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin