Sandbox/Anticoagulation Strategy: Difference between revisions
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==Anticoagulation Strategy== | ==Anticoagulation Strategy== | ||
Shown below is an algorithm depicting the assessment of risk of stroke and the appropriate anticoagulation therapy among patients with AF.<ref name="pmid24685668">{{cite journal| author=January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC, Cigarroa JE et al.| title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2014 | volume= | issue= | pages= | pmid=24685668 | doi=10.1016/j.jacc.2014.03.021 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24685668 }} </ref> | Shown below is an algorithm depicting the assessment of risk of [[stroke]] and the appropriate [[anticoagulation]] therapy among patients with [[AF]].<ref name="pmid24685668">{{cite journal| author=January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC, Cigarroa JE et al.| title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2014 | volume= | issue= | pages= | pmid=24685668 | doi=10.1016/j.jacc.2014.03.021 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24685668 }} </ref> | ||
<span style="font-size:85%">'''Abbreviations:''' '''AF''': Atrial fibrillation; '''INR''': International normalized ratio</span> <br> | <span style="font-size:85%">'''Abbreviations:''' '''AF''': Atrial fibrillation; '''INR''': International normalized ratio</span> <br> |
Revision as of 02:33, 5 May 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]
Anticoagulation Strategy
Shown below is an algorithm depicting the assessment of risk of stroke and the appropriate anticoagulation therapy among patients with AF.[1]
Abbreviations: AF: Atrial fibrillation; INR: International normalized ratio
Assess the absolute and relative risk of bleeding before initiating long term anticoagulation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Non-valvular AF | AF with valvular heart disease | AF with mechanical heart valves | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assess CHA2DS2-VASc scoring risk | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Score 0 | Score 1 | Score ≥ 2 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No antithrombotic therapy | No antithrombotic therapy or may consider an oral anticoagulant or aspirin | Oral antithrombotic therapy: ❑ Warfarin:
❑ Caution:
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Does the patients INR stabilize to the recommended value | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Determine INR every month | Direct thrombin or factor Xa inhibitor: ❑ Dabigatran, rivaroxaban, or apixaban:
❑ Caution:
| Determine INR weekly before stabilization and then every month | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
- For patients with AF undergoing procedures that require interruption of warfarin bridging therapy with unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) is needed.
CHA2DS2-VASc Scoring System
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References
- ↑ January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC, Cigarroa JE; et al. (2014). "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". J Am Coll Cardiol. doi:10.1016/j.jacc.2014.03.021. PMID 24685668.