Use and underuse of oral anticoagulation for stroke prevention in atrial fibrillation: old and new paradigms.
Atrial fibrillation (AF) is the most common sustained arrhythmia of the Western world. The increased ischemic stroke risk of the AF patient is one of the most important clinical issues to manage. Despite the well-known benefit of oral anticoagulation in high-risk AF patients, these drugs are widely underused in daily practice all over the world. We describe old and new paradigms of the use of oral anticoagulation. In the future, increased comprehensibility of stroke risk scores, development of a validated clinical bleed risk score, and new patient and physician user-friendly antithrombotic medication may contribute to improved adequate use of oral anticoagulation in AF patients.
Pisters
Ron
R
Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands. r.pisters@mumc.nl
de Vos
Cees B
CB
Nieuwlaat
Robby
R
Crijns
Harry J G M
HJ
D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
D000925:Anticoagulants