Safe use of antithrombotics for stroke prevention in atrial fibrillation: Consideration of risk assessment tools to support decision-making

Therapeutic Advances in Drug Safety

Volumn 5, Issue 1, 2014, Pages 21-37

  Wang, Yishen ^a   Bajorek, Beata ^a  

^a UNIVERSITY OF TECHNOLOGY SYDNEY   (Australia)

Author keywords

atrial fibrillation; bleeding; decision making; risk assessment; risk versus benefit; stroke; stroke prevention

Indexed keywords

ANTICOAGULANT AGENT;

AGE; ANTICOAGULANT THERAPY; BIBLIOGRAPHIC DATABASE; BLEEDING TENDENCY; CEREBROVASCULAR ACCIDENT; CHADS2 SCORE; CLINICAL ASSESSMENT TOOL; CLINICAL DECISION MAKING; CLINICAL PRACTICE; CLINICAL TRIAL (TOPIC); CONSENSUS DEVELOPMENT; DRUG SAFETY; HEART ATRIUM FIBRILLATION; HUMAN; HYPERTENSION; KIDNEY FAILURE; LIVER FAILURE; MEDICAL HISTORY; MEDICATION ERROR; PATIENT CODING; PRIORITY JOURNAL; REVIEW; RISK ASSESSMENT; RISK FACTOR;

EID: 84898882767     PISSN: 20420986     EISSN: 20420994     Source Type: Journal    
DOI: 10.1177/2042098613506592     Document Type: Review

References (68)

1. Alberts M. Amatangelo M. Bauer K. Braun L. Bussey H. Camm A. Assessing stroke and bleeding risk in AFib: consensus statement on appropriate anticoagulant use, 2013; http://www.agingresearch.org/section/topic/atrialfibrillation/consensusstatement (accessed 17 June 2013).
2. Apostolakis S. Lane D. Guo Y. Buller H. Lip G. (2012) Performance of the HEMORR(2)HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS (evaluating the use of SR34006 compared to warfarin or acenocoumarol in patients with atrial fibrillation) study. J Am Coll Cardiol 60: 861–867.
3. Apostolakis S. Lane D. Guo Y. Buller H. Lip G. (2013) Performance of the HEMORR2HAGES, ATRIA, and HAS-BLED bleeding risk–prediction scores in nonwarfarin anticoagulated atrial fibrillation patients. J Am Coll Cardiol 61: 386–387.
4. Atrial Fibrillation Investigators (1998) Echocardiographic predictors of stroke in patients with atrial fibrillation: a prospective study of 1066 patients from 3 clinical trials. Arch Intern Med 158: 1316–1320.
5. Australian Institute of Health and Welfare (2008) Australia–s health 2008. Cat no AUS 99. Canberra: AIHW.
6. Australian Institute of Health and Welfare (2012) Australia–s health 2012. Australia–s Health Series No 13 (Cat no AUS 156). Canberra: AIHW.
7. Bajorek B. (2011) A review of the safety of anticoagulants in older people using the medicines management pathway: weighing the benefits against the risks. Ther Adv Drug Safety 2(2): 45–58.
8. Bajorek B. Krass I. Ogle S. Duguid M. Shenfield G. (2005) Optimizing the use of antithrombotic therapy for atrial fibrillation in older people: a pharmacist-led multidisciplinary intervention. J Am Geriatrics Soc 53: 1912–1920.
9. Bajorek B. Masood N. Krass I. (2012) Development of a Computerised Antithrombotic Risk Assessment Tool (CARAT) to optimise therapy in older persons with atrial fibrillation. Australas J Ageing 31: 102–109.
10. Bajorek B. Ogle S. Duguid M. Shenfield G. Krass I. (2009) Balancing risk versus benefit: the elderly patient–s perspective on warfarin therapy. Pharm Pract (Internet) 7: 113–123.
11. Bajorek B. Ogle S. Duguid M. Shenfield G. Krass I. Bajorek B. (2007) Management of warfarin in atrial fibrillation: views of health professionals, older patients and their carers. Med J Australia 186: 175–180.
12. Baruch L. Gage B. Horrow J. Juul-Möller S. Labovitz A. Persson M. (2007) Can patients at elevated risk of stroke treated with anticoagulants be further risk stratified? Stroke 38: 2459–2463.
13. Benjamin E. Levy D. Vaziri D. D–Agostino R. Belanger A. Wolf P. (1994) Independent risk factors for atrial fibrillation in a population-based cohort: the Framingham Heart Study. JAMA 271: 840–844.
14. Bereznicki L. Peterson G. Jackson S. Jeffrey E. (2006) The risks of warfarin use in the elderly. Expert Opinion on Drug Safety 5: 417–431.
15. Beyth R. Milligan P. Gage B. (2002) Risk factors for bleeding in patients taking coumarins. Curr Hematol Rep 1: 41–52.
16. Beyth R. Quinn L. Landefeld C. (1998) Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med 105: 91–99.
17. Boddice G. Brauer S. Gustafsson L. Kenardy J. Hoffmann T. (2010) Clinical Guidelines for Stroke Management 2010. Melbourne, Australia: National Stroke Foundation. Available at: http://strokefoundation.com.au/site/media/clinical_guidelines_stroke_managment_2010_interactive.pdf
18. Camm A. Lip G. De Caterina R. Savelieva I. Atar D. Hohnloser S. (2012) 2012 focused update of the ESC Guidelines for the management of atrial fibrillation An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Europace 14: 1385–1413.
19. Connolly S. Ezekowitz M. Yusuf S. Eikelboom J. Oldgren J. Parekh A. (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361: 1139–1151.
20. Connolly S. Laupacis A. Gent M. Roberts R. Cairns J. Joyner C. (1991) Canadian Atrial Fibrillation Anticoagulation (CAFA) Study. J Am Coll Cardiol 18: 349–355.
21. De Breucker S. Herzog G. Pepersack T. (2010) Could geriatric characteristics explain the under-prescription of anticoagulation therapy for older patients admitted with atrial fibrillation? A retrospective observational study. Drugs Aging 27: 807–813
22. European Atrial Fibrillation Trial Study Group (1993) Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 342: 1255–1262.
23. Ezekowitz M. Bridgers S. James K. Carliner N. Colling C. Gornick C. (1992) Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. N Engl J Med 327: 1406–1412.
24. Fang M. Go A. Chang Y. Borowsky L. Pomernacki N. Udaltsova N. (2011) A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol 58: 395–401.
25. Fuster V. Ryden L. Cannom D. Crijns H. Curtis A. Ellenbogen K. (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 57(11): e101–e198.
26. Gage B. Waterman A. Shannon W. Boechler M. Rich M. Radford M. (2001) Validation of clinical classification schemes for predicting stroke. JAMA 285(22): 2864–2870.
27. Gage B. Yan Y. Milligan P. Waterman A. Culverhouse R. Rich M. (2006) Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J 151: 713–719.
28. Go A. Hylek E. Borowsky L. Phillips K. Selby J. Singer D. (1999) Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Ann Intern Med 131: 927–934.
29. Go A. Hylek E. Chang Y. Phillips K. Henault L. Capra A. (2003) Anticoagulation therapy for stroke prevention in atrial fibrillation. JAMA 290: 2685–2692.
30. Granger C. Alexander J. McMurray J. Lopes R. Hylek E. Hanna M. (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365: 981–992.
31. Hart R. Pearce L. Aguilar M. (2007) Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 146: 857–867.
32. Hart R. Pearce L. McBride R. Rothbart R. Asinger R. (1999) Factors Associated With Ischemic Stroke During Aspirin Therapy in Atrial Fibrillation Analysis of 2012 Participants in the SPAF I–III Clinical Trials. Stroke 30: 1223–1229.
33. Heidenreich P. Trogdon J. Khavjou O. Butler J. Dracup K. Ezekowitz M. (2011) Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation 123: 933–944.
34. Hylek E. (2008) Contra: ‘Warfarin should be the drug of choice for thromboprophylaxis in elderly patients with atrial fibrillation–. Caveats regarding use of oral anticoagulant therapy among elderly patients with atrial fibrillation. Thromb Haemost 100: 16–17.
35. Kearon C. Ginsberg J. Kovacs M. Anderson D. Wells P. Julian J. (2003) Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism. N Engl J Med 349: 631–639.
36. Kirchhof P. Auricchio A. Bax J. Crijns H. Camm J. Diener H. (2007) Outcome parameters for trials in atrial fibrillation: executive summary Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eur Heart J 28: 2803–2817.
37. Kuijer P. Hutten B. Prins M. Buller H. (1999) Prediction of the risk of bleeding during anticoagulant treatment for venous thromboembolism. Arch Intern Med 159: 457.
38. Landefeld C. Goldman O. (1989) Major bleeding in outpatients treated with warfarin: incidence and prediction by factors known at the start of outpatient therapy. Am J Med 87: 144–152.
39. Laupacis A. Boysen G. Connolly S. Ezekowitz M. Hart R. James K. (1994) Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Arch Intern Med 154: 1449–1457.
40. Lip G. Banerjee A. Lagrenade I. Lane D. Taillandier S. Fauchier L. (2012) Assessing the risk of bleeding in patients with atrial fibrillation: the Loire Valley Atrial Fibrillation project. Circ Arrhythm Electrophysiol 5: 941–948.
41. Lip G. Frison L. Halperin J. Lane D. (2010a) Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke 41(12): 2731–2738.
42. Lip G. Frison L. Halperin J. Lane D. (2011) Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol 57: 173–180.
43. Lip G. Lane D. Van Walraven C. Hart R. (2006) Additive role of plasma von Willebrand factor levels to clinical factors for risk stratification of patients with atrial fibrillation. Stroke 37: 2294–2300.
44. Lip G. Nieuwlaat R. Pisters R. Lane D. Crijns H. (2010b) Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach. The Euro Heart Survey on Atrial Fibrillation. Chest J 137: 263–272.
45. Nieuwlaat R. Prins M. Le Heuzey J. Vardas P. Aliot E. Santini M. (2008) Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on atrial fibrillation. Eur Heart J 29: 1181–1189.
46. Olesen J. Lip G. Hansen M. Hansen P. Tolstrup J. Lindhardsen J. (2011) Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ 342: d124.
47. Patel M. Mahaffey K. Garg J. Pan G. Singer D. Hacke W. (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365: 883–891.
48. Petersen P. Godtfredsen J. Boysen G. Andersen E. Andersen B. (1989) Placebo-controlled, randomized trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation: The Copenhagen AFASAK Study. Lancet 333: 175–179.
49. Pisters R. Lane D. Nieuwlaat R. de Vos C. Crijns H. Lip G. (2010) A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation. The Euro Heart Survey. Chest J 138: 1093–1100.
50. Poller L. Aronow W. Karalis D. Chandrasekaran K. Mintz G. Petersen P. (1991) The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 325: 129–132.
51. Rietbrock S. Heeley E. Plumb J. van Staa T. (2008) Chronic atrial fibrillation: Incidence, prevalence, and prediction of stroke using the Congestive heart failure, Hypertension, Age> 75, Diabetes mellitus, and prior Stroke or transient ischemic attack (CHADS2) risk stratification scheme. Am Heart J 156: 57–64.
52. Roger V. Go A. Lloyd-Jones D. Adams R. Berry J. Brown T. (2011) Heart disease and stroke statistics - 2011 update: a report from the American Heart Association. Circulation 123(4): e18–e209.
53. Roger V. Go A. Lloyd-Jones D. Benjamin E. Berry J. Borden W. (2012) Heart disease and stroke statistics - 2012 update: a report from the American Heart Association. Circulation 125(1): e2–e220.
54. Roldan V. Marin F. Fernandez H. Manzano-Fernandez S. Gallego P. Valdes M. (2013) Predictive value of the HAS-BLED and ATRIA bleeding scores for the risk of serious bleeding in a ‘real-world– population with atrial fibrillation receiving anticoagulant therapy. Chest 143: 179–184.
55. Ruíz-Giménez N. Suárez C. González R. Nieto J. Todolí J. Samperiz A. (2008) Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry. Thromb Haemost Stuttgart 100: 26.
56. Shireman T. Mahnken J. Howard P. Kresowik T. Hou Q. Ellerbeck E. (2006) Development of a contemporary bleeding risk model for elderly warfarin recipients. Chest J 130: 1390–1396.
57. Skanes A. Healey J. Cairns J. Dorian P. Gillis A. McMurtry M. (2012) Focused 2012 Update of the Canadian Cardiovascular Society Atrial Fibrillation Guidelines: Recommendations for stroke prevention and rate/rhythm control. Can J Cardiol 28: 125–136.
58. Stroke Prevention in Atrial Fibrillation Investigators (1995) Risk factors for thromboembolism during aspirin therapy in patients with atrial fibrillation: The Stroke Prevention in Atrial Fibrillation Study. J Stroke Cerebrovasc Dis 5: 147–157.
59. The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators (1990) The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 323: 1505–1511.
60. The Columbus Investigators (1997) Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. N Engl J Med 337: 657–662.
61. Tulner L. Van Campen J. Kuper I. Gijsen G. Koks C. Mac Gillavry M. (2010) Reasons for undertreatment with oral anticoagulants in frail geriatric outpatients with atrial fibrillation: a prospective, descriptive study. Drugs Aging 27: 39–50.
62. Van Latum J. Koudstaal P. Venables G. Van Gijn J. Kappelle L. Algra A. (1995) Predictors of major vascular events in patients with a transient ischemic attack or minor ischemic stroke and with nonrheumatic atrial fibrillation. Stroke 26(5): 801–806.
63. Van Staa T. Setakis E. Di Tanna G. Lane D. Lip G. (2011) A comparison of risk stratification schemes for stroke in 79,884 atrial fibrillation patients in general practice. J Thromb Haemost 9: 39–48.
64. van Walraven C. Hart R. Singer D. Laupacis A. Connolly S. Petersen P. (2002) Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: An individual patient meta-analysis. JAMA 288: 2441–2448.
65. Wang T. Massaro J. Levy D. Vasan R. Wolf P. D–Agostino R. (2003) A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community. JAMA 290: 1049–1056.
66. Wann L. Curtis A. January C. Ellenbogen K. Lowe J. Estes N. III. (2011) 2011 ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Updating the 2006 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Heart Rhythm 8: 157–176.
67. Wolf P. Abbott R. Kannel W. (1991) Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 22: 983–988.
68. You J. Singer D. Howard P. Lane D. Eckman M. Fang M. (2012) Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl.): e531S-e575S.