Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and Perspectives

Marcel Levi; F. D. Richard Hobbs; Alan K Jacobson; Ron Pisters; Domenico Prisco; Artur Bernardo; Markus Haas; Jens Heidrich; Matt Rosenberg; Jørn Dalsgaard Nielsen; Walter A Wuillemin

doi:10.1055/s-0029-1240013

Seminars in Thrombosis and Hemostasis, Inhaltsverzeichnis

Semin Thromb Hemost 2009; 35(6): 527-542
DOI: 10.1055/s-0029-1240013

Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and Perspectives

Marcel Levi¹ , F. D. Richard Hobbs² , Alan K. Jacobson³ , Ron Pisters⁴ , Domenico Prisco⁵ , Artur Bernardo⁶ , Markus Haas⁷ , Jens Heidrich⁸ , Matt Rosenberg⁹ , Jørn Dalsgaard Nielsen¹⁰ , Walter A. Wuillemin¹¹

¹Department of Vascular Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
²Primary Care Clinical Sciences, University of Birmingham, UK
³Loma Linda University School of Medicine, Department of Anticoagulation Services, Cardiology Section, Loma Linda VA Medical Center, Loma Linda, CA, USA
⁴Department of Cardiology, University Hospital of Maastricht, The Netherlands
⁵Department of Medical and Surgical Critical Care, Thrombosis Centre, University Hospital Careggi, Florence, Italy
⁶Department of Cardiology, Klinik Gais, Gais, Switzerland
⁷Theresienkrankenhaus, Academic Hospital, Mannheim, Germany
⁸Laboratory Dr. von Froreich & Kollegen GmbH, Hamburg, Germany
⁹General Practitioner, Jackson, Michigan, USA
¹⁰Thrombosis Centre, Gentofte Hospital, Hellerup, Denmark
¹¹Division of Haematology, Luzerner Kantonsspital and University of Bern, Switzerland

Abstract

ABSTRACT

Despite overwhelming evidence of the benefits of risk-adjusted oral anticoagulation on stroke reduction in patients with atrial fibrillation (AF), there is still considerable undertreatment. A multidisciplinary expert group was formed to discuss issues surrounding anticoagulant treatment of patients with AF to try and achieve consensus on various aspects of the implementation of guidelines on oral anticoagulation therapy in AF. Panel members were cardiologists, hematologists, and laboratory and primary care physicians with specific expertise from Europe and the United States. One of the most important conclusions of the meeting was to enhance guideline adherence by better communication of the data showing that the benefits of stroke reduction outweigh the risk of bleeding associated with treatment with vitamin K antagonists. Management of oral anticoagulation therapy by dedicated centers, such as anticoagulation clinics, or by patient self-management may improve the quality of anticoagulation and facilitate the management of these patients and thereby further facilitate optimal antithrombotic management in patients with AF.

KEYWORDS

Atrial fibrillation - anticoagulation - warfarin - Coumadin - cerebrovascular thrombosis - thromboembolism - bleeding

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Referenzen

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Marcel LeviM.D.

Department Internal Medicine, Academic Medical Centre F-4

Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

eMail: m.m.levi@amc.uva.nl