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Updated Guidelines Issued on Anticoagulation Prophylaxis for Stroke in NVAF — Physician’s First Watch

Medical News |
February 25, 2014

Updated Guidelines Issued on Anticoagulation Prophylaxis for Stroke in NVAF

By Joe Elia

The American Academy of Neurology has issued revised guidelines on preventing stroke in the face of nonvalvular atrial fibrillation (NVAF). The guidelines, which appear in Neurology, take into account the new oral anticoagulants.

Among the recommendations are these:

  • In patients with cryptogenic stroke, outpatient monitoring studies lasting a week or longer could identify those with NVAF.

  • Inform patients with NVAF of their increased risk for stroke and of the ability of antithrombotic therapy to reduce it, but acknowledge the dangers for major bleeds.

  • If warfarin is used, target INR between 2 and 3.

  • If choosing among the newer oral anticoagulants (e.g., dabigatran, rivaroxaban, or apixaban) consider creatinine levels, age, and body weight.

Reader Comments (9)

Joel M Wolkowicz, MDCM, FACC Physician, Cardiology

Define NVAF

Carlo Saitto MD Physician, Health Law/Ethics/Public Policy, RMC Health Authority Rome ITALY

I'd have expected a less ambiguous assessment. Are the new anticoagulants a needed addition to treatment opportunities or just a mere alternative non superior option?
If we are still waiting for a definite answer maybe we can wait for updated guidelines

mohamed kechrid Physician, Nephrology, security forces hospital Riyadh KSA

Thank you for the update. Brief,yet to the point.

EMANUEL GOLDBERG Physician, Cardiology, Nyc

Ditto

Ricardo Pontes Physician, Family Medicine/General Practice, Brazil

This is an important issue.Some patients died because of therapy instead of disease

LAWRENCE SAIDMAN Physician, Anesthesiology, retired

What would be the recommendation for a 75 yo woman with a recent history of midbrain infarct (MRI) but no residual effects, normal CT, normal carotid ultrasound, normal transthoracic echo, no PFO, well controlled AODM (A1C 5.8) currently taking Aggrenox?

Mohammed Alsabri

Agee
With!

ARAM TOMASIAN

avoid new anticoagulants on basis ofsafety from use of warfarin.

ARAM TOMASIAN

will contiue warfarin on basis of long history ofcausing low major bleeds.

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