ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Fuster, Valentín; Rydén, Lars; Cannom, David S.; Crijns, Harry J.G.M.; Curtis, Anne B.; Ellenbogen, Kenneth A.; Halperin, Jonathan L.; Heuzey, J.-Y. Le; Kay, G. Neal; Lowe, James E.; Olsson, Sandra; Prystowsky, Eric N.; Tamargo, Juan; Wann, Samuel; Smith, Sidney C.; Jacobs, Alice K.; Adams, Cynthia D.; Anderson, J. Lawford; Antman, Elliott M.; Hunt, Sharon A.; Nishimura, Rick A.; Ornato, Joseph P.; Page, Richard L.; Riegel, Bárbara; Priori, Silvia G.; Blanc, Jean Jacques; Budaj, Andrzej; Camm, A. John; Dean, Veronica; Deckers, Jaap W.; Despres, Catherine; Dickstein, Kenneth; Lekakis, John; McGregor, Keith; Metra, Marco; Morais, João; Osterspey, A.; Zamorano, José Luís

doi:10.1161/circulationaha.106.177292

Cited by 1,876 publications

(613 citation statements)

References 999 publications

Supporting

Mentioning

589

Contrasting

Unclassified

Order By: Relevance

“…Antithrombotic therapy substantially reduces the risk of thromboembolic stroke associated with atrial fibrillation (AF) 1, 2, 3, 4, 5. Antithrombotic use for stroke prophylaxis in AF is associated with increased risk of major bleeding, with 1‐year major bleeding risk ranging from 2% to 4% in anticoagulated AF patients 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

O’Brien

Holmes

Thomas

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundOral anticoagulation (OAC) reduces stroke risk in atrial fibrillation, but bleeding is a frequent side effect. The decision to discontinue or modify medication regimens in response to a bleeding event may differ according to bleeding site and severity.Methods and ResultsWe used data from a large, national outpatient registry, ORBIT‐AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation; 2010–2011), to evaluate event characteristics and OAC management following the first bleeding event occurring during follow‐up. Bleeding events were classified into 3 categories: (1) International Society of Thrombosis and Hemostasis major bleeding, (2) clinically relevant nonmajor bleeding requiring medical attention, and (3) nuisance bleeding not requiring medical attention (eg, bruising, hemorrhoidal bleeding). Of 9743 patients enrolled in ORBIT‐AF with follow‐up data, 510 (3.23/100 subject‐years) experienced a major bleed, 615 (3.90/100 subject‐years), experienced a clinically relevant nonmajor bleed, and 1558 (9.87/100 subject‐years) experienced a nuisance bleed, among first bleeds over 2 years. Nearly one third of patients (31.6%) discontinued OAC therapy following a major bleeding event, 12.7% following a clinically relevant nonmajor bleed, and 4.5% following a nuisance bleed. Compared with those who experienced a clinically relevant nonmajor or nuisance bleed, patients who experienced a major bleed were more likely to be black and female and to have a history of heart failure and stroke. Those who discontinued were more likely to have central nervous system or gastrointestinal bleeding than those who persisted on OAC therapy.ConclusionsOverall, 1 in 3 patients who experienced a major bleed was no longer anticoagulated after the event. Those who discontinued OAC were more likely to have central nervous system or gastrointestinal bleeding than those who persisted on OAC.

show abstract

Section: Introductionmentioning

confidence: 99%

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

O’Brien

Holmes

Thomas

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…The CHADS 2 and CHA 2 DS 2 ‐VASc scores are risk assessment tools to predict stroke in patients with atrial fibrillation (AF)3 and can be used to guide anticoagulation therapy,4, 5 in complement with or as a substitute of other risk scores for AF 6. The CHA 2 DS 2 ‐VASc score has been proved to be more sensitive than the CHADS 2 score to predict cardio‐embolic events in AF patients 7.…”

Section: Introductionmentioning

confidence: 99%

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

et al. 2016

View full text Add to dashboard Cite

AimsAtrial fibrillation (AF) is common in patients with heart failure (HF). CHA2DS2‐VASc score was originally employed as a risk assessment tool for stroke in patients with AF; however, it has recently been used to predict not only stroke but also various cardiovascular diseases beyond the original AF field. We aimed to verify the CHA2DS2‐VASc score as a risk assessment tool to predict mortality in patients with HF.Methods and ResultsConsecutive 1011 patients admitted for treatment of HF were divided into three groups based on their CHA2DS2‐VASc scores: score 1–3 group (n = 317), score 4–6 group (n = 549) and score 7–9 group (n = 145). Of the 1011 HF patients, 387 (38.3%) had AF. We compared patient characteristics among the three groups and prospectively followed for all‐cause mortality. Although left ventricular ejection fraction was similar among all three groups, all‐cause mortality was higher in the score 4–6 group and score 7–9 group than in the score 1–3 group (37.9 and 29.3% vs. 15.1%, log‐rank P < 0.001). In the multivariable Cox proportional hazard analysis, the CHA2DS2‐VASc score 7–9 was an independent predictor of all‐cause mortality (all HF patients: hazard ratio (HR) 1.822, P = 0.011; HF patients with AF: HR 1.951, P = 0.031; HF patients without AF: HR 2.215, P = 0.033).ConclusionsThe CHA2DS2‐VASc score was an independent predictor of all‐cause mortality in HF patients with or without AF. This comprehensive risk assessment score may help identify HF patients who are at high risk for mortality in HF patient.

show abstract

“…In primary or secondary prophylactic treatment of patients with AF, AC and APT have each been shown to be a better alternative than a placebo, with warfarin better than APT but with an increased risk of bleeding (Alberts, Eikelboom, & Hankey, 2012; Blackshear et al., 1996; Connolly et al., 2008; Fuster et al., 2006; Hart, Pearce, & Aguilar, 2007; Hylek et al., 2003; Laupacis et al., 1994). Novel oral anticoagulants (NOACs) have been reported to have the same effects or to perform even better than warfarin with an equal or lower risk of major bleeding (Alberts et al., 2012; Hankey, 2014; Hori et al., 2013; Lopes et al., 2012), and NOACs have shown large differences in their favor regarding the risk of stroke or systemic embolism, compared with ASA (Alberts et al., 2012; Diener et al., 2012).…”

Section: Introductionmentioning

confidence: 99%

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Eriksson

2016

Brain and Behavior

View full text Add to dashboard Cite

ObjectivesTo assess long‐term prognosis after transient ischemic attack (TIA)/subtypes of stroke relative to secondary prophylactic treatment(s) given.Materials and MethodsRetro/prospective follow‐up of patients hospitalized in the Stroke Unit or in the Department of Neurology, Linköping, in 1986 and followed up to Feb. 2011.ResultsA total of 288 men were followed up for 2254 years (mean 7.8 years) and 261 women for 1984 years (mean 7.6 years). In men, the distribution to anticoagulants (AC) (warfarin treatment) was 18%, antiplatelet therapy (APT) usually ASA 75 mg/day 54%, untreated 27%, unknown 2%. In women, the distribution to AC was 15%, APT 60%, untreated 23%, unknown 2%, respectively. Mortality rates at 1 year, 10 years, and 25 years for men were 21%, 67%, and 93%, respectively, versus the rates in women of 24%, 71%, and 90%, respectively. Survival curves showed markedly increased risk of death compared to the normal population. AC treatment was more favorable for men regarding the annual risk of stroke, compared with APT (9.4% vs. 9.8%), as well as the risks of MI, (5.6% vs. 6.7%), and death (8.1% vs. 10.3%), compared to women for stroke (11.6% vs. 8.8%) and MI (5.3% vs. 3.7%) but not for death (8.3% vs. 8.4%). The risk of fatal bleeding was 0.86% annually on AC compared to 0.17% on APT. According to Cox regression analysis included patients with TIA/ischemic stroke, first‐line treatment had beneficial effects on survival: AC OR 0.67 (0.5–0.9), APT 0.67 (0.52–0.88) versus untreated.ConclusionsPatients with a history of TIA/stroke had a higher mortality rate versus controls, providing support for both primary and secondary prophylaxis regarding vascular risk factors for death. This study also provided support for secondary prophylactic treatment with either AC or ASA (75 mg once daily) to reduce the vascular risk of death unless there are contraindications.

show abstract

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Cited by 1,876 publications

References 999 publications

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Contact Info

Product

Resources

About

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Cited by 1,876 publications

References 999 publications

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

Therapeutic Strategies Following Major, Clinically Relevant Nonmajor, and Nuisance Bleeding in Atrial Fibrillation: Findings From ORBIT‐AF

The CHA2DS2‐VASc score as a predictor of high mortality in hospitalized heart failure patients

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Contact Info

Product

Resources

About

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients