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Review
. 2016 Jan 15:4:26-39.
doi: 10.1016/j.ebiom.2016.01.017. eCollection 2016 Feb.

Emerging Tools for Stroke Prevention in Atrial Fibrillation

Christos Voukalis  1 , Gregory Y H Lip  1 , Eduard Shantsila  1
Affiliations
Review

Emerging Tools for Stroke Prevention in Atrial Fibrillation

Christos Voukalis et al. EBioMedicine. .

Abstract

Ischaemic strokes resulting from atrial fibrillation (AF) constitute a devastating condition for patients and their carers with huge burden on health care systems. Prophylactic treatment against systemic embolization and ischaemic strokes is the cornerstone for the management of AF. Effective stroke prevention requires the use of the vitamin K antagonists or non-vitamin K oral anticoagulants (NOACs). This article summarises the latest developments in the field of stroke prevention in AF and aims to assist physicians with the choice of oral anticoagulant for patients with non-valvular AF with different risk factor profile.

Keywords: Atrial fibrillation; CKD, chronic kidney disease; CrCl, creatinine clearance; DM, diabetes mellitus; ESRF, end stage renal failure; HF, heart failure; HTN, hypertension; ICH, intracranial haemorrhage; INR, international normalised ratio; LV, left ventricle; NCB, net clinical benefit; NICE, National institute for Health and Care Excellence; NVAF, non-valvular atrial fibrillation; Net clinical benefit; Non-vitamin K oral anticoagulants; Oral anticoagulation; PCI, percutaneous coronary intervention; RSM, risk stratification model; Risk stratification; SE, systemic embolism; Stroke prevention; TE, thromboembolic episode; TIA, transient ischaemic attack; TTR, time in therapeutic range; eGFR, estimated glomerular filtration rate.

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Figures

Fig. 1
Fig. 1
Algorithm for risk stratification and selection of anticoagulation therapy for stroke prevention in atrial fibrillation. Abbreviations: CHA2DS2-VASc: C, congestive heart failure, H, hypertension, A2,age at least 75 years (× 2), D, diabetes, S2, previous stroke, TIA, or systemic embolism, V, vascular disease,(× 2) A, age 65 through 74 years, Sc, sex category female sex. HAS-BLED: H, hypertension, A, abnormal renal and liver function, S, stroke, B, bleeding tendency, L, labile INRs, E, elderly, D, drugs. SAMe-TT2R2: S, sex (female), A, age (< 60 y), Me, medical history, T, treatment (interacting drugs), T2, tobacco use (× 2), R2, race (not white)(× 2). TTR, time in therapeutic range. VKA: vitamin K antagonists. NOAC: Non-vitamin K oral anticoagulant.
See this image and copyright information in PMC

References

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