Treatment pathways for atrial fibrillation: simplifying the approach to thromboprophylaxis

Potpara, Tatjana; Lip, Gregory Y. H.

doi:10.1111/j.1742-1241.2011.02816.x

International Journal of Clinical Practice

2011

DOI: 10.1111/j.1742-1241.2011.02816.x

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Treatment pathways for atrial fibrillation: simplifying the approach to thromboprophylaxis

Tatjana Potpara

Gregory Y. H. Lip²

Abstract: Linked Comment: http://dx.doi.org/10.1111/j.1742-1241.2011.02818.x.

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Cited by 2 publications

References 16 publications

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Clopidogrel, Aspirin and Proton Pump Inhibition after Percutaneous Valve Implants: An Update

Fusari¹

2013

CPD

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TAVR is a new technology that compresses a tissue valve onto an expandable stent. Technical and procedural issues have been solved, but strokes and major bleeding still affect patients' life despite double antiplatelet therapy given to reduce MACCE. To balance pros and cons, antithrombotic therapy with Warfarin or new anticoagulants can be used in patients with previous AF or NOAF to prevent stroke; while single antiplatelet with PPI is a better alternative in patients with liver disease, gastric ulcer or drug abuse to avoid bleeding events. While waiting for randomized trials, a tailored therapy based upon physician's experience and close patient follow-up is the safest, most effective treatment.

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Clopidogrel, Aspirin and Proton Pump Inhibition after Percutaneous Valve Implants: An Update

Fusari¹

2013

CPD

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Prevention of thromboembolic complications of atrial fibrillation: Current aspects and perspective

Potpara¹,

Licina²,

Polovina³

et al. 2012

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Atrijalna fibrilacija (AF) predstavlja najčešću srčanu aritmiju od koje boluje 1-2% svetske populacije. Glavni ciljevi u njenom lečenju su prevencija tromboembolijskih komplikacija i lečenje simptoma uzrokovanih ovom aritmijom. Tokom više decenija antagonisti vitamina K (VKA) bili su jedini dostupni lekovi za prevenciju tromboembolizma u AF. Poznato je da je upotreba ovih lekova povezana sa nizom poteškoća koje se odnose na njihovo produženo dejstvo, individualne varijacije uslovljene interakcijama sa hranom, alkoholom i drugim lekovima. Takođe, uzak terapijski opseg ovih lekova zahteva redovne laboratorijske kontrole i monitoring. Poslednjih nekoliko godina završeno je više randomizovanih kliničkih studija faze III koje su poredile efekat novih oralnih antikoagulantnih lekova sa varfarinom u prevenciji trombo-embolizma u AF. Novi lekovi su podeljeni u dve grupe: oralni direktni inhibitori trombina (dabigatran) i oralni direktni inhibitori faktora Xa (rivaroksaban i apiksaban). Prednost novih lekova leži u manjem broju klinički značajnih interakcija sa hranom i drugim lekovima i odsustvu potrebe za redovnim laboratorijskim praćenjem antikoagulantnog efekta, uz jednaku efikasnost u prevenciji tromboembolija i manju učestalost značajnih krvarenja u poređenju sa VKA. Tromboprofilaksa u AF može se vršiti i nefarmakološkim putem, tj. perkutanom transkateterskom mehaničkom okluzijom aurikule leve pretkomore. Do sada je konstruisano nekoliko mehaničkih okludera, a ovaj vid prevencije služi kao alternativa kod bolesnika sa AF koji su iskusili značajne hemoragijske komplikacije pri primeni VKA ili kod kojih je primena VKA kontraindikovana. U ovom radu sumirana su dosadašnja saznanja o dobro poznatim i novim oralnim antikoagulansima, kao i o nefarmakološkim metodama prevencije moždanog udara i trombo-embolizma u AF. atrijalna fibrilacija, tromboembolija SažetakKljučne reči

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Treatment pathways for atrial fibrillation: simplifying the approach to thromboprophylaxis

Abstract: Linked Comment: http://dx.doi.org/10.1111/j.1742-1241.2011.02818.x.

Cited by 2 publications

References 16 publications

Clopidogrel, Aspirin and Proton Pump Inhibition after Percutaneous Valve Implants: An Update

Clopidogrel, Aspirin and Proton Pump Inhibition after Percutaneous Valve Implants: An Update

Prevention of thromboembolic complications of atrial fibrillation: Current aspects and perspective

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