Stroke prevention in atrial fibrillation: Past, present and future Comparing the guidelines and practical decision-making

被引:265
作者
Lip, Gregory Y. H. [1 ,2 ,3 ]
Freedman, Ben [4 ,5 ,6 ]
De Caterina, Raffaele [7 ,8 ]
Potpara, Tatjana S. [3 ,9 ]
机构
[1] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England
[2] Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark
[3] Univ Belgrade, Sch Med, Belgrade, Serbia
[4] Univ Sydney, Heart Res Inst, Sydney Med Sch, Charles Perkins Ctr, Sydney, NSW, Australia
[5] Univ Sydney, Concord Hosp, Dept Cardiol, Sydney, NSW, Australia
[6] Univ Sydney, Concord Hosp, Anzac Res Inst, Sydney, NSW, Australia
[7] Univ G dAnnunzio, Chieti, Italy
[8] Ctr Excellence Aging CeSI Met, Chieti, Italy
[9] Clin Ctr Serbia, Cardiol Clin, Belgrade, Serbia
关键词
Atrial fibrillation; stroke prevention; non-vitamin K antagonist oral anticoagulants; warfarin; VITAMIN-K ANTAGONIST; MAJOR BLEEDING RISK; DAILY-CARE PATIENTS; VS. USUAL CARE; ISCHEMIC-STROKE; CHA(2)DS(2)-VASC SCORE; ANTITHROMBOTIC THERAPY; ELDERLY-PATIENTS; ORAL ANTICOAGULANTS; COST-EFFECTIVENESS;
D O I
10.1160/TH16-11-0876
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Concepts and our approaches to stroke prevention in atrial fibrillation (AF) have changed markedly over the last decade. There has been an evolution over the approach to stroke and bleeding risk assessment, as well as new treatment options. An increasing awareness of AF has led to calls to improve the detection of and population screening for AF Stroke and bleeding risk assessment continues to evolve, and the ongoing debate on balance between simplicity and practicality, against precision medicine will continue. In this review article, we provide an overview of past, present and the (likely) future concepts and approaches to stroke prevention in AF We propose three simple steps (the Birmingham '3-step') that offers a practical management pathway to help streamline and simplify decision-making for stroke prevention in patients with AF.
引用
收藏
页码:1230 / 1239
页数:10
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