Updated Guidelines Issued on Anticoagulation Prophylaxis for Stroke in NVAF — Physician’s First Watch
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)
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
Thank you for the update. Brief,yet to the point.
This is an important issue.Some patients died because of therapy instead of disease
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?
avoid new anticoagulants on basis ofsafety from use of warfarin.
will contiue warfarin on basis of long history ofcausing low major bleeds.