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Title: | Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary | Authors: | HEIDBUCHEL, Hein Verhamme, Peter Alings, Marco Antz, Matthias Diener, Hans-Christoph Hacke, Werner Oldgren, Jonas Sinnaeve, Peter Camm, A. John Kirchhof, Paulus |
Issue Date: | 2017 | Publisher: | OXFORD UNIV PRESS | Source: | EUROPEAN HEART JOURNAL, 38(27), p. 2137-2149 | Abstract: | In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for acute management of coronary interventions, step-down schemes for long-term combined antiplatelet-anticoagulant management in coronary heart disease, management of bleeding, and cardioversion under NOAC therapy. The Updated Guide is available in full in EP Europace (Heidbuchel H, Verhamme P, Alings M, Antz M, Diener HC, HackeW, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, Advisors. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507), while additional resources can be found at the related ESC/EHRA website (www.NOACforAF.eu). | Notes: | [Heidbuchel, Hein] Hasselt Univ & Heart Ctr, Stadsomvaart 11, B-3500 Hasselt, Belgium. [Verhamme, Peter; Sinnaeve, Peter] Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium. [Alings, Marco] Amphia Ziekenhuis, Dept Cardiol, Breda, Netherlands. [Antz, Matthias] Klinikum Oldenburg, Dept Cardiol, Oldenburg, Germany. [Diener, Hans-Christoph] Univ Duisburg Essen, Univ Hosp Essen, Dept Neurol, Essen, Germany. [Hacke, Werner] Ruprecht Karls Univ Heidelberg, Dept Neurol, Heidelberg, Germany. [Oldgren, Jonas] Uppsala Univ, Dept Med Sci, Uppsala Clin Res Ctr, Uppsala, Sweden. [Camm, A. John] St Georges Univ, Clin Cardiol, London, England. [Kirchhof, Paulus] Univ Birmingham, Ctr Cardiovasc Sci, Birmingham, W Midlands, England. [Kirchhof, Paulus] Univ Munster, Dept Cardiol & Angiol, Munster, Germany. | Keywords: | Atrial fibrillation; Anticoagulation; Stroke; Bleeding; Pharmacology; Non-VKA oral anticoagulants; NOAC;atrial fibrillation; anticoagulation; stroke; bleeding; pharmacology; Non-VKA oral anticoagulants; NOAC | Document URI: | http://hdl.handle.net/1942/24367 | ISSN: | 0195-668X | e-ISSN: | 1522-9645 | DOI: | 10.1093/eurheartj/ehw058 | ISI #: | 000405499800015 | Rights: | Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2016 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | Research publications |
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heidbuchel 1.pdf Restricted Access | Published version | 1.2 MB | Adobe PDF | View/Open Request a copy |
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