Vitamin K antagonist use for all patients with hypertrophic cardiomyopathy and atrial fibrillation: analysis of the literature and guideline review.
Hypertrophic cardiomyopathy (HCM), which was first described in 1958, occurs in approximately one in 500 people. Patients with HCM are at an increased risk of atrial fibrillation, which is not only poorly tolerated in this population, but also increases their risk of an embolic event. The incidence of stroke in HCM patients with atrial fibrillation is approximately 21-23%. Given the high risk of stroke, antithrombotic therapy with warfarin is recommended in national guidelines. This therapy should be used without regard to other risk factors for stroke that may be present. Anticoagulation with the new oral anticoagulants may be considered as an alternative; although, specific data for patients with HCM is not available. The purpose of this review is to remind practitioners of the importance of stroke prophylaxis with oral anticoagulants in this population.
Methodist University Hospital, Department of Pharmacy, 1265 Union Avenue, Memphis, TN 38104, USA.
Carrie S
CS
Oliphant
Justin
J
McCullough
Taimoor
T
Hashim
Rami N
RN
Khouzam
D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin