Template:Anticoagulation in atrial fibrillation

Anticoagulation Therapy

  • ACCP Recommendations
    • In patients with AF, including those with paroxysmal AF, with only one of the risk factors listed immediately above, we recommend long-term antithrombotic therapy (Grade 1A), either as anticoagulation with an oral VKA, such as warfarin (Grade 1A), or as aspirin, at a dose of 75-325 mg/d (Grade 1B)[1]
    • In patients with AF, including those with paroxysmal AF, who have two or more of the risk factors we recommend long-term anticoagulation with an oral VKA (Grade 1A).[1]
  • CCS Recommendations
    • Oral anticoagulants are recommended for all AF patients aged 65 or older or who have any one of the traditional CHADS2 risk factors of stroke, hypertension, heart failure, or diabetes (remember as CHADS-65). Otherwise, patients with a history of coronary artery disease or arterial vascular disease should be prescribed ASA. CCS recommends that the first choice for oral anticoagulation should be the novel direct-acting oral anticoagulants (i.e. NOACs, for non-valvular AF). The big paradigm change is that ED physicians should prescribe OACs to at-risk AF patients before they leave the ED.[2]
  • 1.0 1.1 Singer DE et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).Chest. 2008 Jun;133(6 Suppl):546S-592S
  • Verma A, et al. 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation Canadian Journal of Cardiology 30 (2014) 1114e1130