Abstract
The past year has seen the publication of results of the largest and arguably the most significant clinical trials of antithrombotic to prevent stroke and systemic throm-boembolism in patients with atrial fibrillation (AF) (1-3). In 2011, results of two trials concerning anticoagulation in patients with AF in addition to RE-LY study were also published (4-6). Canadian AF guidelines has been updated early this year, incorporating the new evidence (7). Also in 2012, the American College of Chest Physicians has released guidelines for the antithrombotic therapy of atrial fibril- alation (8). Similar updates of ESC and AHA/ACC guidelines are expected, which will be published in the upcoming months. Additionally in 2012, a consensus statement on interventional treatment of atrial fibrillation has been released by HRS/EHRA/ECAS (9). In the present review, new studies will be discussed in the context of current best evidence and their impact on the antithrombotic management of patients with AF will be examined. In ade-dition we present our current clinical practice regarding anticoagulation in patients with AF at Heart Centre Uni-versity of Leipzig.
Highlights
The past year has seen the publication of results of the largest and arguably the most significant clinical trials of antithrombotic to prevent stroke and systemic thromboembolism in patients with atrial fibrillation (AF) [1,2,3]
Current ACC/AHA and CCS guidelines recommend the Clinical Implications of Recent Trials on Anticoagulation application of the CHADS2 Score, whereas the CHA2DS2VASc Score is recommended by the European guidelines (Figure 1) as a risk stratification tool to assess the risk of stroke and thromboembolism (TE) [1,2,3, 7]
This recommendation is based on the above mentioned studies which showed that Dabigatran and Apixaban had greater efficacy and Rivaroxaban had similar efficacy for stroke prevention compared to Warfarin in patients with non valvular AF [4,5,6]
Summary
The past year has seen the publication of results of the largest and arguably the most significant clinical trials of antithrombotic to prevent stroke and systemic thromboembolism in patients with atrial fibrillation (AF) [1,2,3]. In 2011, results of two trials concerning anticoagulation in patients with AF in addition to RE-LY study were published [4,5,6]. Canadian AF guidelines has been updated early this year, incorporating the new evidence [7]. New studies will be discussed in the context of current best evidence and their impact on the antithrombotic management of patients with AF will be examined.
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