Stroke prevention in atrial fibrillation: Putting the guidelines into practice

Drugs and Aging

Volumn 27, Issue 11, 2010, Pages 859-870

  Mant, Jonathan ^a   Edwards, Duncan ^a  

^a UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

Anticoagulants, therapeutic use; Antiplatelets, therapeutic use; Aspirin, therapeutic use; Atrial fibrillation; Dabigatran etexilate, therapeutic use; Factor X inhibitors, therapeutic use; Research and development; Stroke, prevention; Thrombin inhibitors, therapeutic use; Vitamin K antagonists, therapeutic use; Warfarin, therapeutic use

Indexed keywords

ACENOCOUMAROL; ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; ANTIVITAMIN K; CLOPIDOGREL; DABIGATRAN ETEXILATE; DIPYRIDAMOLE; IDRAPARINUX; THROMBIN INHIBITOR; TRIFLUSAL; WARFARIN; XIMELAGATRAN;

ANTICOAGULATION; BLEEDING; BRAIN HEMORRHAGE; CLINICAL TRIAL; GASTROINTESTINAL HEMORRHAGE; HEART ATRIUM FIBRILLATION; HIGH RISK PATIENT; HUMAN; INTERNATIONAL NORMALIZED RATIO; LIVER INJURY; MEDICAL DECISION MAKING; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; RISK REDUCTION; STROKE; TREATMENT INDICATION;

AGED; AGED, 80 AND OVER; AGING; ANTICOAGULANTS; ATRIAL FIBRILLATION; DRUG MONITORING; DRUG THERAPY, COMBINATION; FIBRINOLYTIC AGENTS; HEMORRHAGE; HUMANS; INTERNATIONAL NORMALIZED RATIO; MIDDLE AGED; PLATELET AGGREGATION INHIBITORS; PRACTICE GUIDELINES AS TOPIC; RISK FACTORS; STROKE;

EID: 77958587552     PISSN: 1170229X     EISSN: 11791969     Source Type: Journal    
DOI: 10.2165/11538620-000000000-00000     Document Type: Review

References (63)

1. National Collaborating Centre for Chronic Conditions. Atrial fibrillation: national clinical guideline for management in primary and secondary care. London: Royal College of Physicians, 2006
2. Levy S, Camm AJ, Saksena S, et al. International consensus on nomenclature and classification of atrial fibrillation; a collaborative project of the Working Group on Arrhythmias and the Working Group on Cardiac Pacing of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Europace 2003; 5 (2): 119-22 (Pubitemid 36372367)
3. Mant J, Wade DT, Winner S. Health care needs assessment: stroke. In: Stevens A, Raftery J, Mant J, et al., editors. Health care needs assessment: the epidemiologically based needs assessment reviews, first series. 2nd ed. Oxford: Radcliffe Medical Press, 2004: 141-244
4. Fitzmaurice DA, Hobbs FDR, Jowett S, et al. Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. BMJ 2007; 335: 383
5. Levy S, Maarek M, Cournel P, et al. Characterisation of different subsets of atrial fibrillation in general practice in France: the ALFA Study. Circulation 1999; 99: 3028-35
6. Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 74: 236-41
7. Kannel WB, Wolf PA, Benjamin EJ, et al. Prevalence, in- cidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998; 82: 2-9N
8. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham study. Stroke 1991; 22: 983-88
9. Rothwell PM, Coull AJ, Giles MF, et al. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet 2004; 363: 925-33
10. Stroke Risk in Atrial Fibrillation Working Group. Independent predictors of stroke in patients with atrial fibrillation: a systematic review. Neurology 2007; 69: 546-54
11. Stroke Risk in Atrial Fibrillation Working Group. Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillation. Stroke 2008; 39: 1901-10
12. Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001; 285: 2864-70
13. Mant J, Hobbs FD, Fletcher K, et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet 2007; 370: 493-503 (Pubitemid 47212371)
14. Aguilar MI, Hart R. Oral anticoagulants for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischaemic attacks. Cochrane Database Syst Rev 2005; (2): CD001927
15. Agilar MI, Hart R. Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischaemic attacks. Cochrane Database Syst Rev 2005; (4): CD001925
16. Van Walraven C, Hart RG, Singer DE, et al. Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. JAMA 2002; 288: 2441-8
17. Mant JWF, Richards SH, Hobbs R, et al. Protocol for Birmingham Atrial Fibrillation Treatment of the Aged study (BAFTA): a randomised controlled trial of warfarin versus aspirin for stroke prevention in the management of atrial fibrillation in an elderly primary care population. BMC Cardiovasc Disord 2003; 3: 9
18. Rash A, Downes T, Portner R, et al. A randomised controlled trial of warfarin versus aspirin for stroke prevention in octogenarians with atrial fibrillation (WASPO). Age Ageing 2007; 37: 151-6
19. van Walraven C, Hart RG, Connolly S, et al. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the Atrial Fibrillation Investigators. Stroke 2009; 40: 1410-6
20. The ACTIVE Writing Group on behalf of the ACTIVE Investigators. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367: 1903-12
21. The Active Investigators. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 2009; 360: 2066-78
22. ESPRIT Study Group. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 2006; 367: 1665-73
23. Stroke Prevention in Atrial Fibrillation Investigators. Adjusted dose warfarin versus low intensity, fixed dose warfarin plus aspirin for high risk patients with atrial fibrillation: stroke prevention in atrial fibrillation III randomised clinical trial. Lancet 1996; 348: 633-8
24. Perez-Gomez F, Alegria E, Berjon J, et al. Comparative effects of antiplatelet, anticoagulant, or combined therapy in patients with valvular and nonvalvular atrial fibrillation: a randomized multicenter study. JACC 2004; 44: 1557-66
25. Antithrombotic Trialists' Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009; 373: 1849-60
26. Lip GY, Boos CJ. Antithrombotic treatment in atrial fibrillation. Heart 2006; 92: 155-61
27. Lip GYH. Don't add aspirin for associated stable vascular disease in a patient with atrial fibrillation receiving anticoagulation. BMJ 2008; 336: 614-5
28. Dentali F, Douketis JD, Lim W, et al. Combined aspirinoral anticoagulant therapy compared with oral anticoagulant therapy alone among patients at risk for cardiovascular disease: a meta-analysis of randomised trials. Arch Intern Med 2007; 167: 117-24
29. Hurlen M, Abdelnoor M, Smith P, et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 2002; 347: 969-74
30. Flaker GC, Gruber M, Connolly SJ, et al. Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trial. Am Heart J 2006; 152: 967-73
31. Hart RG, Benavente O, Pearce LA. Increased risk of intracranial haemorrhage when aspirin is combined with warfarin: a meta-analysis and hypothesis. Cerebrovasc Dis 1999; 9: 215-7
32. The Medical Research Council's General Practice Research Framework. Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. Lancet 1998; 351: 233-41
33. Connolly SJ, Eikelboom J, O'Donnell M, et al. Challenges of establishing new antithrombotic therapies in atrial fibrillation. Circulation 2007; 116: 449-55
34. SPORTIF III Investigators. Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial. Lancet 2003; 362: 1691-8
35. SPORTIF Executive Steering Committee for the SPORTIF V Investigators. Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation: a randomized trial. JAMA 2005; 293: 690-8
36. The AMADEUS Investigators. Comparison of idraparinux with vitamin K antagonists for prevention of thrombo-embolism in patients with atrial fibrillation: a randomised, open-label, non-inferiority trial. Lancet 2008; 371: 315-21
37. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-51
38. Hart RG, Pearce LA. Current status of stroke risk stratification in patients with atrial fibrillation. Stroke 2009; 40: 2607-10
39. National Collaborating Centre for Chronic Conditions. Atrial fibrillation: the management of atrial fibrillation. NICE Clinical Guideline 36. London: National Institute for Health and Clinical Excellence, 2006
40. Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: executive summary. Circulation 2006; 114: 700-52
41. Singer DE, Albers GW, Dalen JE, et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (6 Suppl.): 546s-92s
42. Healey JS, Hart RG, Pogue J, et al. Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE-W). Stroke 2008; 39: 1482-6
43. Lee BH, Park JS, Park JH, et al. The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 score 1. J Cardiovasc Electrophysiol 2010; 21 (5): 501-7
44. Gorin L, Faucheir L, Nonin E, et al. Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1. Thromb Haemost 2010; 103: 833-40
45. Singer DE, Chang Y, Fang MC. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med 2009; 151: 297-305
46. Sato H, Ishikawa K, Kitabatake A, et al. Low dose aspirin for prevention of stroke in low risk patients with atrial fibrillation. Japan Atrial Fibrillation Stroke Trial. Stroke 2006; 37: 447-51
47. Schulman S, Beyth RJ, Kearon C, et al. Haemorrhagic complications of anticoagulant and thrombolytic treatment. American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (6 Suppl.): 257s-98s
48. Hutten BA, Lensign AW, Kraaijenhagen RA, et al. Safety of treatment with oral anticoagulants in the elderly: a systematic review. Drugs Aging 1999; 14: 303-12
49. Laupacis A, Boysen G, Connolly S, et al. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Arch Intern Med 1994; 154: 1449-57
50. Shireman TI, Howard PA, Kresowik TF, et al. Combined anticoagulant- antiplatelet use and major bleeding events in elderly atrial fibrillation patients. Stroke 2004; 35: 2362-7
51. Hylek EM, Evans-Molina C, Shea C, et al. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007; 115: 2689-96
52. Palareti G, Hirsh H, Legnani C, et al. Bleeding complications of oral anticoagulant treatment: an inception-cohort prospective collaborative study (ISCOAT). Lancet 1996; 348: 423-8
53. Connolly SJ, Pogue J, Eikelboom J, et al. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centres and countries as measured by time in therapeutic range. Cicrulation 2008; 118: 2029-37
54. Heneghan C, Alonso-Coello P, Garcia-Alamino JM, et al. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. Lancet 2006 Feb 4; 367 (9508): 404-11 (Pubitemid 43184260)
55. Poller L, Keown M, Ibrahim S, et al. An international multicenter randomized study of computer-assisted oral anticoagulant dosage vs. medical staff dosage. J Thromb Haemost 2008 Jun; 6 (6): 935-43
56. Aquilante CL, Langaee TY, Lopez LM, et al. Influence of coagulation factor, vitamin K epoxide reductase complex subunit 1, and cytochrome P450 2C9 gene polymorphisms on warfarin dose requirements. Clin Pharmacol Ther 2006; 79: 291-302
57. Klein TE, Altman RB, Eriksson N, et al. Estimation of the warfarin dose with clinical and pharmacogenetic data. N Engl J Med 2009 Feb 19; 360 (8): 753-64
58. Kangelaris KN, Bent S, Nussbaum RL, et al. Genetic testing before anticoagulation? A systematic review of pharma-cogenetic dosing of warfarin. J Gen Intern Med 2009 May; 24 (5): 656-64
59. Pisters R, Lane DA, Nieuwlaat R, et al. A novel userfriendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest. Epub 2010 Mar 18
60. Gage BF, Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J 2006 Mar; 151 (3): 713-9
61. Palareti G, Cosmi B. Bleeding with anticoagulation therapy - who is at risk, and how best to identify such patients. Thromb Haemost 2009 Aug; 102 (2): 268-78
62. Hylek EM, Go AS, Chang Y, et al. Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation. N Engl J Med 2003; 349: 1019-26
63. Serebruany VL, Steinbuhl SR, Berger PB, et al. Analysis of risk of bleeding complications after different doses of aspirin in 192036 patients enrolled in 31randomised controlled trials. Am J Cardiol 2005; 95: 1218-22