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Stroke Prevention in Atrial Fibrillation

Stroke Prevention in Atrial Fibrillation ImportanceAtrial fibrillation (AF) is associated with an increase in mortality and morbidity, with a substantial increase in stroke and systemic thromboembolism. Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home than strokes unrelated to AF. ObjectiveTo provide an overview of current concepts and recent developments in stroke prevention in AF, with suggestions for practical management. Evidence ReviewA comprehensive structured literature search was performed using MEDLINE for studies published through March 11, 2015, that reported on AF and stroke, bleeding risk factors, and stroke prevention. FindingsThe risk of stroke in AF is reduced by anticoagulant therapy. Thromboprophylaxis can be obtained with vitamin K antagonists (VKA, eg, warfarin) or a non-VKA oral anticoagulant (NOAC). Major guidelines emphasize the important role of oral anticoagulation (OAC) for effective stroke prevention in AF. Initially, clinicians should identify low-risk AF patients who do not require antithrombotic therapy (ie, CHA2DS2-VASc score, 0 for men; 1 for women). Subsequently, patients with at least 1 stroke risk factor (except when the only risk is being a woman) should be offered OAC. A patient’s individual risk of bleeding from antithrombotic therapy should be assessed, and modifiable risk factors for bleeding should be addressed (blood pressure control, discontinuing unnecessary medications such as aspirin or nonsteroidal anti-inflammatory drugs). The international normalized ratio should be tightly controlled for patients receiving VKAs. Conclusions and RelevanceStroke prevention is central to the management of AF, irrespective of a rate or rhythm control strategy. Following the initial focus on identifying low-risk patients, all others with 1 or more stroke risk factors should be offered OAC. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Stroke Prevention in Atrial Fibrillation

Lip, Gregory Y. H.; Lane, Deirdre A.
JAMA , Volume 313 (19) – May 19, 2015
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Publisher
American Medical Association
Copyright
Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2015.4369
pmid
25988464
Publisher site
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Abstract

ImportanceAtrial fibrillation (AF) is associated with an increase in mortality and morbidity, with a substantial increase in stroke and systemic thromboembolism. Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home than strokes unrelated to AF. ObjectiveTo provide an overview of current concepts and recent developments in stroke prevention in AF, with suggestions for practical management. Evidence ReviewA comprehensive structured literature search was performed using MEDLINE for studies published through March 11, 2015, that reported on AF and stroke, bleeding risk factors, and stroke prevention. FindingsThe risk of stroke in AF is reduced by anticoagulant therapy. Thromboprophylaxis can be obtained with vitamin K antagonists (VKA, eg, warfarin) or a non-VKA oral anticoagulant (NOAC). Major guidelines emphasize the important role of oral anticoagulation (OAC) for effective stroke prevention in AF. Initially, clinicians should identify low-risk AF patients who do not require antithrombotic therapy (ie, CHA2DS2-VASc score, 0 for men; 1 for women). Subsequently, patients with at least 1 stroke risk factor (except when the only risk is being a woman) should be offered OAC. A patient’s individual risk of bleeding from antithrombotic therapy should be assessed, and modifiable risk factors for bleeding should be addressed (blood pressure control, discontinuing unnecessary medications such as aspirin or nonsteroidal anti-inflammatory drugs). The international normalized ratio should be tightly controlled for patients receiving VKAs. Conclusions and RelevanceStroke prevention is central to the management of AF, irrespective of a rate or rhythm control strategy. Following the initial focus on identifying low-risk patients, all others with 1 or more stroke risk factors should be offered OAC.

Journal

JAMA – American Medical Association

Published: May 19, 2015

References

  • Atrial fibrillation, stroke risk, and warfarin therapy revisited: a population-based study.
    Björck, S; Palaszewski, B; Friberg, L; Bergfeldt, L
  • Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why?
    Lip, GY
  • 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation.
    Camm, AJ; Lip, GY; De Caterina, R
  • 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.
    January, CT; Wann, LS; Alpert, JS
  • Mechanisms of thrombogenesis in atrial fibrillation: Virchow’s triad revisited.
    Watson, T; Shantsila, E; Lip, GY
  • Use of warfarin in non-rheumatic atrial fibrillation: a commentary from general practice.
    Sweeney, KG; Gray, DP; Steele, R; Evans, P
  • Independent predictors of stroke in patients with atrial fibrillation: a systematic review.
  • Stroke and thromboembolism in atrial fibrillation.
    Pisters, R; Lane, DA; Marin, F; Camm, AJ; Lip, GY
  • Is female sex a risk factor for stroke and thromboembolism in patients with atrial fibrillation? a systematic review and meta-analysis.
    Wagstaff, AJ; Overvad, TF; Lip, GY; Lane, DA
  • Assessment of female sex as a risk factor in atrial fibrillation in Sweden: nationwide retrospective cohort study.
    Friberg, L; Benson, L; Rosenqvist, M; Lip, GY
  • Female sex as a risk factor for stroke in atrial fibrillation: a nationwide cohort study.
    Mikkelsen, AP; Lindhardsen, J; Lip, GY; Gislason, GH; Torp-Pedersen, C; Olesen, JB
  • Risk factors for stroke and thromboembolism in relation to age among patients with atrial fibrillation: the Loire Valley Atrial Fibrillation Project.
    Olesen, JB; Fauchier, L; Lane, DA; Taillandier, S; Lip, GY
  • Atrial fibrillation and the risk of ischemic stroke: does it still matter in patients with a CHA2DS2-VASc score of 0 or 1?
    Chao, TF; Liu, CJ; Chen, SJ
  • Refinement of ischemic stroke risk in patients with atrial fibrillation and CHA2DS2-VASc score of 1.
    Huang, D; Anguo, L; Yue, WS; Yin, L; Tse, HF; Siu, CW
  • The impact of atherosclerotic vascular disease in predicting a stroke, thromboembolism and mortality in atrial fibrillation patients: a systematic review.
    Anandasundaram, B; Lane, DA; Apostolakis, S; Lip, GY
  • Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation.
  • Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study.
    Friberg, L; Rosenqvist, M; Lip, GY
  • Risk factors and incidence of ischemic stroke in Taiwanese with nonvalvular atrial fibrillation—a nationwide database analysis.
    Lin, LY; Lee, CH; Yu, CC
  • Factors associated with ischemic stroke during aspirin therapy in atrial fibrillation: analysis of 2012 participants in the SPAF I-III clinical trials.
    Hart, RG; Pearce, LA; McBride, R; Rothbart, RM; Asinger, RW
  • Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials.
  • Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation.
    Gage, BF; Waterman, AD; Shannon, W; Boechler, M; Rich, MW; Radford, MJ
  • A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study.
    Wang, TJ; Massaro, JM; Levy, D
  • A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin.
    van Walraven, C; Hart, RG; Wells, GA
  • Chronic atrial fibrillation: Incidence, prevalence, and prediction of stroke using the congestive heart failure, hypertension, age >75, diabetes mellitus, and prior stroke or transient ischemic attack (CHADS2) risk stratification scheme.
    Rietbrock, S; Heeley, E; Plumb, J; van Staa, T
  • Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation.
    Lip, GY; Nieuwlaat, R; Pisters, R; Lane, DA; Crijns, HJ
  • Derivation and validation of QStroke score for predicting risk of ischaemic stroke in primary care and comparison with other risk scores: a prospective open cohort study.
    Hippisley-Cox, J; Coupland, C; Brindle, P
  • A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score.
    Singer, DE; Chang, Y; Borowsky, LH
  • Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
    You, JJ; Singer, DE; Howard, PA
  • 2014 focused update of the Canadian Cardiovascular Society Guidelines for the management of atrial fibrillation.
    Verma, A; Cairns, JA; Mitchell, LB
  • The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study.
    Olesen, JB; Torp-Pedersen, C; Hansen, ML; Lip, GY
  • Meta-Analysis of CHADS2 versus CHA2DS2-VASc for predicting stroke and thromboembolism in atrial fibrillation patients independent of anticoagulation.
    Zhu, W-G; Xiong, Q-M; Hong, K
  • The CHADS2 score for stroke risk stratification in atrial fibrillation—friend or foe?
    Karthikeyan, G; Eikelboom, JW
  • Risk of stroke and intracranial hemorrhage in 9727 Chinese with atrial fibrillation in Hong Kong.
    Siu, CW; Lip, GY; Lam, KF; Tse, HF
  • Validation of contemporary stroke and bleeding risk stratification scores in non-anticoagulated Chinese patients with atrial fibrillation.
    Guo, Y; Apostolakis, S; Blann, AD
  • Prognosis in patients with atrial fibrillation and CHA2DS2-VASc Score = 0 in a community-based cohort study.
    Taillandier, S; Olesen, JB; Clémenty, N
  • Balancing stroke and bleeding risks in patients with atrial fibrillation and renal failure: the Swedish Atrial Fibrillation Cohort study.
    Friberg, L; Benson, L; Lip, GY
  • Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) and ATRIA (AnTicoagulation and Risk Factors In Atrial Fibrillation) study cohorts.
    Piccini, JP; Stevens, SR; Chang, Y
  • Using the CHA2DS2-VASc score for refining stroke risk stratification in ‘low-risk’ Asian patients with atrial fibrillation.
    Chao, TF; Liu, CJ; Wang, KL
  • The value of the European Society of Cardiology guidelines for refining stroke risk stratification in patients with atrial fibrillation categorized as low risk using the anticoagulation and risk factors in atrial fibrillation stroke score: a nationwide cohort study.
    Lip, GY; Nielsen, PB; Skjoth, F; Lane, DA; Rasmussen, LH; Larsen, TB
  • Cardiac biomarkers are associated with an increased risk of stroke and death in patients with atrial fibrillation: a Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) substudy.
    Hijazi, Z; Oldgren, J; Andersson, U
  • Prognostic value of plasma von Willebrand factor and soluble P-selectin as indices of endothelial damage and platelet activation in 994 patients with nonvalvular atrial fibrillation.
    Conway, DS; Pearce, LA; Chin, BS; Hart, RG; Lip, GY
  • Additive role of plasma von Willebrand factor levels to clinical factors for risk stratification of patients with atrial fibrillation.
    Lip, GY; Lane, D; Van Walraven, C; Hart, RG
  • Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study.
    Go, AS; Fang, MC; Udaltsova, N
  • Stroke risk in atrial fibrillation: do we anticoagulate CHADS2 or CHA2DS2-VASc ≥1, or higher? [published online March 6, 2015].
    Olesen, JB; Torp-Pedersen, C
  • Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.
    Lip, GY; Andreotti, F; Fauchier, L
  • Stroke and bleeding risk co-distribution in real-world patients with atrial fibrillation: the Euro Heart Survey.
    Marcucci, M; Lip, GY; Nieuwlaat, R; Pisters, R; Crijns, HJ; Iorio, A
  • Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin.
    Beyth, RJ; Quinn, LM; Landefeld, CS
  • Prediction of the risk of bleeding during anticoagulant treatment for venous thromboembolism.
    Kuijer, PM; Hutten, BA; Prins, MH; Büller, HR
  • Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF).
    Gage, BF; Yan, Y; Milligan, PE
  • Development of a contemporary bleeding risk model for elderly warfarin recipients.
    Shireman, TI; Mahnken, JD; Howard, PA; Kresowik, TF; Hou, Q; Ellerbeck, EF
  • A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey.
    Pisters, R; Lane, DA; Nieuwlaat, R; de Vos, CB; Crijns, HJ; Lip, GY
  • A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study.
    Fang, MC; Go, AS; Chang, Y
  • The HAS-BLED score has better prediction accuracy for major bleeding than CHADS2 or CHA2DS2-VASc scores in anticoagulated patients with atrial fibrillation.
    Roldán, V; Marín, F; Manzano-Fernández, S
  • Comparison of the CHADS2, CHA2DS2-VASc and HAS-BLED scores for the prediction of clinically relevant bleeding in anticoagulated patients with atrial fibrillation: the AMADEUS trial.
    Apostolakis, S; Lane, DA; Buller, H; Lip, GY
  • Assessing the risk of bleeding in patients with atrial fibrillation: the Loire Valley Atrial Fibrillation project.
    Lip, GY; Banerjee, A; Lagrenade, I; Lane, DA; Taillandier, S; Fauchier, L
  • Performance of the HEMORR 2 HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in nonwarfarin anticoagulated atrial fibrillation patients.
    Apostolakis, S; Lane, DA; Guo, Y; Buller, H; Lip, GY
  • The HAS-BLED score predicts bleedings during bridging of chronic oral anticoagulation: results from the national multicentre BNK Online Bridging Registry (BORDER).
    Omran, H; Bauersachs, R; Rübenacker, S; Goss, F; Hammerstingl, C
  • Triple antithrombotic therapy following an acute coronary syndrome: prevalence, outcomes and prognostic utility of the HAS-BLED score.
    Smith, JG; Wieloch, M; Koul, S
  • Integrating real-time clinical information to provide estimates of net clinical benefit of antithrombotic therapy for patients with atrial fibrillation.
    Eckman, MH; Wise, RE; Speer, B
  • Risk of falls and major bleeds in patients on oral anticoagulation therapy.
    Donzé, J; Clair, C; Hug, B
  • Choosing antithrombotic therapy for elderly patients with atrial fibrillation who are at risk for falls.
    Man-Son-Hing, M; Nichol, G; Lau, A; Laupacis, A
  • Prior history of falls and risk of outcomes in atrial fibrillation: the Loire Valley Atrial Fibrillation Project.
    Banerjee, A; Clementy, N; Haguenoer, K; Fauchier, L; Lip, GY
  • Composite risk scores and composite endpoints in the risk prediction of outcomes in anticoagulated patients with atrial fibrillation: the Loire Valley Atrial Fibrillation Project.
    Banerjee, A; Fauchier, L; Bernard-Brunet, A; Clementy, N; Lip, GY
  • Development of a novel composite stroke and bleeding risk score in patients with atrial fibrillation: the AMADEUS Study.
    Lip, GY; Lane, DA; Buller, H; Apostolakis, S
  • Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation.
    Hart, RG; Pearce, LA; Aguilar, MI
  • A differential effect of aspirin in prevention of stroke on atrial fibrillation.
  • Effect of age on stroke prevention therapy in patients with atrial fibrillation: the Atrial Fibrillation Investigators.
    van Walraven, C; Hart, RG; Connolly, S
  • Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review.
    Wan, Y; Heneghan, C; Perera, R
  • Cessation of oral anticoagulation in relation to mortality and the risk of thrombotic events in patients with atrial fibrillation.
    Gallego, P; Roldan, V; Marín, F
  • Vitamin K antagonists in heart disease: current status and perspectives (Section III). Position paper of the ESC Working Group on Thrombosis—Task Force on Anticoagulants in Heart Disease.
    De Caterina, R; Husted, S; Wallentin, L
  • Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.
    Ruff, CT; Giugliano, RP; Braunwald, E
  • Indirect comparison studies—are they useful? insights from the novel oral anticoagulants for stroke prevention in atrial fibrillation.
    Skjøth, F; Larsen, TB; Rasmussen, LH
  • Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation.
    Skjøth, F; Larsen, TB; Rasmussen, LH; Lip, GY
  • Edoxaban in the evolving scenario of non vitamin K antagonist oral anticoagulants imputed placebo analysis and multiple treatment comparisons.
    Verdecchia, P; Angeli, F; Lip, GY; Reboldi, G
  • Safety and efficacy of nonvitamin K oral anticoagulants in nonvalvular atrial fibrillation: a Bayesian meta-analysis approach.
    Verdecchia, P; Angeli, F; Bartolini, C
  • Initiation of warfarin in patients with atrial fibrillation: early effects on ischaemic strokes.
    Azoulay, L; Dell’Aniello, S; Simon, TA; Renoux, C; Suissa, S
  • Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT₂R₂ score.
    Apostolakis, S; Sullivan, RM; Olshansky, B; Lip, GY
  • A prospective validation of the SAME-TT2R2 score: how to identify atrial fibrillation patients who will have good anticoagulation control on warfarin.
    Poli, D; Antonucci, E; Testa, S; Lip, GY
  • Relationship of the SAMe-TT₂R₂ score to poor-quality anticoagulation, stroke, clinically relevant bleeding, and mortality in patients with atrial fibrillation.
    Lip, GY; Haguenoer, K; Saint-Etienne, C; Fauchier, L
  • SAMe-TT2R2 score, time in therapeutic range, and outcomes in anticoagulated patients with atrial fibrillation.
    Gallego, P; Roldán, V; Marin, F
  • Evaluation of SAMe-TT2R2 risk score for predicting the quality of anticoagulation control in a real-world cohort of patients with non-valvular atrial fibrillation on vitamin-K antagonists [published online February 6, 2015].
    Abumuaileq, RR; Abu-Assi, E; Raposeiras-Roubin, S
  • The net clinical benefit of warfarin anticoagulation in atrial fibrillation.
    Singer, DE; Chang, Y; Fang, MC
  • Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a ‘real world’ nationwide cohort study.
    Olesen, JB; Lip, GY; Lindhardsen, J
  • Net clinical benefit of warfarin in patients with atrial fibrillation: a report from the Swedish atrial fibrillation cohort study.
    Friberg, L; Rosenqvist, M; Lip, GY
  • Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus no treatment in a ‘real world’ atrial fibrillation population: a modelling analysis based on a nationwide cohort study.
    Banerjee, A; Lane, DA; Torp-Pedersen, C; Lip, GY
  • Potential net clinical benefit of population-wide implementation of apixaban and dabigatran among European patients with atrial fibrillation.
    Pisters, R; Nieuwlaat, R; Lane, DA; Crijns, HJ; Lip, GY
  • Moving the tipping point: the decision to anticoagulate patients with atrial fibrillation.
    Eckman, MH; Singer, DE; Rosand, J; Greenberg, SM
  • ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation.
    Fuster, V; Rydén, LE; Cannom, DS
  • Underuse of oral anticoagulants in atrial fibrillation: a systematic review.
    Ogilvie, IM; Newton, N; Welner, SA; Cowell, W; Lip, GY
  • Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation?
    Chao, TF; Liu, CJ; Wang, KL
  • Oral anticoagulation, aspirin or no therapy in patients with nonvalvular AF with 0 or 1 stroke risk factor based on the CHA2DS2-VASc score.
    Lip, GY; Skjøth, F; Rasmussen, LH; Larsen, TB
  • Atrial fibrillation patients categorized as “not for anticoagulation” according to the 2014 Canadian Cardiovascular Society algorithm are not “low risk”.
    Lip, GY; Nielsen, PB; Skjøth, F; Rasmussen, LH; Larsen, TB
  • The value of the European Society of Cardiology guidelines for refining stroke risk stratification in patients with atrial fibrillation categorized as low risk using the anticoagulation and risk factors in atrial fibrillation stroke score: a nationwide cohort study.
    Lip, GY; Nielsen, PB; Skjøth, F; Lane, DA; Rasmussen, LH; Larsen, TB
  • The risks of risk scores for stroke risk assessment in atrial fibrillation.
    Nielsen, PB; Chao, TF
  • Stroke risk reduction with oral anticoagulation using CHA2DS−-VASc in a Japanese AF population: a modeling analysis.
    Senoo, K; Lane, DA; Lip, GY
  • Prognosis and guideline-adherent antithrombotic treatment in patients with atrial fibrillation and atrial flutter: implications of undertreatment and overtreatment in real-life clinical practice: the Loire Valley Atrial Fibrillation Project.
    Gorin, L; Fauchier, L; Nonin, E; Charbonnier, B; Babuty, D; Lip, GY
  • Guideline-adherent antithrombotic treatment is associated with improved outcomes compared with undertreatment in high-risk patients with atrial fibrillation.
    Nieuwlaat, R; Olsson, SB; Lip, GY
  • Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database.
    Lip, GY; Clemens, A; Noack, H; Ferreira, J; Connolly, SJ; Yusuf, S
  • Stroke and bleeding in atrial fibrillation with chronic kidney disease.
    Olesen, JB; Lip, GY; Kamper, AL
  • Renal impairment in a “real-life” cohort of anticoagulated patients with atrial fibrillation (implications for thromboembolism and bleeding).
    Roldán, V; Marín, F; Fernández, H
  • Atrial fibrillation in CKD: balancing the risks and benefits of anticoagulation.
    Ng, KP; Edwards, NC; Lip, GY; Townend, JN; Ferro, CJ
  • Net clinical benefit of antithrombotic therapy in patients with atrial fibrillation and chronic kidney disease: a nationwide observational cohort study.
    Bonde, AN; Lip, GY; Kamper, AL
  • Anticoagulation in patients with atrial fibrillation undergoing coronary stent implantation.
    Bernard, A; Fauchier, L; Pellegrin, C
  • The optimal management of patients on oral anticoagulation undergoing coronary artery stenting.
    Rubboli, A; Faxon, DP; Juhani Airaksinen, KE
  • Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS).
    Lip, GY; Windecker, S; Huber, K
  • Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).
    Steinberg, BA; Peterson, ED; Kim, S
  • Perioperative management of antithrombotic therapy and prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
    Douketis, JD; Spyropoulos, AC; Spencer, FA
  • Perioperative bridging anticoagulation during dabigatran or warfarin interruption among patients who had an elective surgery or procedure. Substudy of the RE-LY trial.
    Douketis, JD; Healey, JS; Brueckmann, M
  • Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial.
    Holmes, DR; Reddy, VY; Turi, ZG
  • Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial.
    Holmes, DR; Kar, S; Price, MJ
  • EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion.
    Meier, B; Blaauw, Y; Khattab, AA
  • Rivaroxaban vs vitamin K antagonists for cardioversion in atrial fibrillation.
    Cappato, R; Ezekowitz, MD; Klein, AL
  • Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion.
    Nagarakanti, R; Ezekowitz, MD; Oldgren, J
  • Efficacy and safety of apixaban in patients after cardioversion for atrial fibrillation: insights from the ARISTOTLE Trial (Rivaroxaban Once-daily, oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation).
    Flaker, G; Lopes, RD; Al-Khatib, SM
  • Patient’s values and preferences for stroke prevention in atrial fibrillation: balancing stroke and bleeding risk with oral anticoagulation.
    Lane, DA; Lip, GY
  • Adherence to dabigatran therapy and longitudinal patient outcomes: insights from the veterans health administration.
    Shore, S; Carey, EP; Turakhia, MP
  • Evaluation of patients’ attitudes towards stroke prevention and bleeding risk in atrial fibrillation.
    Lahaye, S; Regpala, S; Lacombe, S
  • Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study.
    Devereaux, PJ; Anderson, DR; Gardner, MJ
  • A method to determine the optimal intensity of oral anticoagulant therapy.
    Rosendaal, FR; Cannegieter, SC; van der Meer, FJ; Briët, E