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Review
. 2021 May 28:16:e23.
doi: 10.15420/ecr.2020.43. eCollection 2021 Feb.

Direct Oral Anticoagulants in Asian Patients with Atrial Fibrillation: Consensus Recommendations by the Asian Pacific Society of Cardiology on Strategies for Thrombotic and Bleeding Risk Management

Daniel Tt Chong  1 , Felicita Andreotti  2 , Peter Verhamme  3 , Jamshed Dalal  4 , Noppacharn Uaprasert  5 , Chun-Chieh Wang  6 , Young Keun On  7 , Yi-Heng Li  8 , Jun Jiang  9 , Koji Hasegawa  10 , Khalid Almuti  11 , Rong Bai  12 , Sidney Th Lo  13 , Rungroj Krittayaphong  14 , Lai Heng Lee  15 , David Kl Quek  16 , Sofian Johar  17 , Swee-Chong Seow  18 , Christopher J Hammett  19 , Jack Wc Tan  1   15   20
Affiliations
Review

Direct Oral Anticoagulants in Asian Patients with Atrial Fibrillation: Consensus Recommendations by the Asian Pacific Society of Cardiology on Strategies for Thrombotic and Bleeding Risk Management

Daniel Tt Chong et al. Eur Cardiol. .

Abstract

The disease burden of AF is greater in Asia-Pacific than other areas of the world. Direct oral anticoagulants (DOACs) have emerged as effective alternatives to vitamin K antagonists (VKA) for preventing thromboembolic events in patients with AF. The Asian Pacific Society of Cardiology developed this consensus statement to guide physicians in the management of AF in Asian populations. Statements were developed by an expert consensus panel who reviewed the available data from patients in Asia-Pacific. Consensus statements were developed then put to an online vote. The resulting 17 statements provide guidance on the assessment of stroke risk of AF patients in the region, the appropriate use of DOACs in these patients, as well as the concomitant use of DOACs and antiplatelets, and the transition to DOACs from VKAs and vice versa. The periprocedural management of patients on DOAC therapy and the management of patients with bleeding while on DOACs are also discussed.

Keywords: AF; Asia; bleeding; consensus; haemostasis; non-vitamin K antagonist oral anticoagulants; vitamin K antagonist.

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Conflict of interest statement

Disclosure: This work was funded through the Asian Pacific Society of Cardiology with unrestricted educational grants from Abbott Vascular, Amgen, AstraZeneca, Bayer and Roche Diagnostics. DC has received honoraria from Abbott, Biotronik, Boston Scientific, Boehringer Ingelheim, Johnson & Johnson, Medtronic and Pfizer. FA has received honoraria outside the present work from Amgen, Bayer, BI, BMS, Daiichi Sankyo and Pfizer. PV has received honoraria from Bayer, BI, BMS, Daiichi Sankyo, Leo Pharma, Pfizer and Portola; and research grants from Bayer, Boehringer Ingelheim and Bristol Meyers Squibb. JJD has received honoraria from Bayer and Pfizer. CCW has received honoraria and research grants from Bayer, BI, Daiichi Sankyo and Pfizer. YHL has received honoraria from Amgen, AstraZeneca, Bayer, BI, Daiichi Sankyo, Roche and Sanofi. JJ has received honoraria from Abbott Vascular, Amgen, AstraZeneca, Bayer, Boston Scientific, Medtronic and Pfizer. STHL has received honoraria and travel support from Abbott, Bayer, Bioexcel, BI, Boston Scientific, Medtronic and Pfizer. LHL has received education and travel grants from Sanofi. DQ has received honoraria from Bayer and Pfizer. SJ has received honoraria from Biosense Webster and Medtronic. SCS has received honoraria from Abbott, Bayer, Biotronik and Medtronic. CJH has received honoraria from Amgen, Bayer, BI and Pfizer-MSD. JWCT has received honoraria from Abbott Vascular, Amgen, AstraZeneca, Bayer, Boston Scientific, BI, Medtronic, Orbus Neich and Biotronik; and research grants from Abbott Diagnostics and Beckmann. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Direct Oral Anticoagulant Dosing with Respect to Renal Function
Figure 2:
Figure 2:. Antithrombotic Therapy in AF patients with Acute Coronary Syndrome or Post-percutaneous Coronary Intervention
Figure 3:
Figure 3:. Periprocedural Management of Patients on Direct Oral Anticoagulants
Figure 4:
Figure 4:. Strategies for Bleeding Management While on Direct Oral Anticoagulants
Figure 5:
Figure 5:. Management Strategy After Major Bleeding Episode
See this image and copyright information in PMC

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