[Risk stratification for thromboembolism and antithrombotic prophylaxis in atrial fibrillation]

Giuseppe Di Pasquale, Letizia Riva
Giornale Italiano di Cardiologia 2012, 13 (11 Suppl 1): 11S-18S
Atrial fibrillation (AF) is associated with a significantly high risk of stroke and systemic embolism (4.5%/year). Oral anticoagulant therapy (OAT) with warfarin (INR range 2.0-3.0) significantly reduces thromboembolic risk, whereas aspirin has poor efficacy. In patients with AF, several scoring systems, such as the CHADS2 and CHA2DS2-VASc scores, are currently used to stratify thromboembolic risk. The CHA2DS2-VASc score stratifies patients at intermediate-low thromboembolic risk more accurately than the CHADS2 score. The most recent European and US guidelines on AF have extended the indications for OAT, which is recommended not only for patients at high risk, but also for those at intermediate risk, with CHADS2 score ≥1. However, in clinical practice underuse of OAT, suboptimal quality of anticoagulation, and frequent discontinuations of treatment are observed. Therefore, there is a great expectation for the new oral anticoagulants, in particular the direct thrombin inhibitor dabigatran etexilate and the factor Xa inhibitors rivaroxaban and apixaban, which are at least non-inferior to warfarin and safer, and seem to be a suitable therapeutic alternative to the old warfarin.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"