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The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation : executive summary

Steffel, Jan, (författare)
Univ Heart Ctr Zurich, Dept Cardiol, Ramistr 100, CH-8091 Zurich, Switzerland
Verhamme, Peter, (författare)
Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium
Potpara, Tatjana S., (författare)
Univ Belgrade, Sch Med, Belgrade, Serbia
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Albaladejo, Pierre, (författare)
Grenoble Alps Univ Hosp, Grenoble, France
Antz, Matthias, (författare)
City Hosp Braunschweig, Braunschweig, Germany
Desteghe, Lien, (författare)
Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium
Haeusler, Karl Georg, (författare)
Charite Univ Med Berlin, Ctr Stroke Res Berlin, Berlin, Germany;Charite Univ Med Berlin, Dept Neurol, Berlin, Germany
Oldgren, Jonas, 1964- (författare)
Uppsala universitet, Uppsala kliniska forskningscentrum (UCR), Uppsala universitet, Kardiologi
Reinecke, Holger, (författare)
Univ Hosp Munster, Dept Cardiovasc Med, Munster, Germany
Roldan-Schilling, Vanessa, (författare)
Univ Murcia, Murcia, Spain
Rowell, Nigel, (författare)
Tallaght Hosp, Age Related Hlth Care & Stroke Serv, Dublin, Ireland
Sinnaeve, Peter, (författare)
Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium
Collins, Ronan, (författare)
St Georges Univ, Cardiol Clin Acad Grp, Mol & Clin Sci Inst, London, England
Camm, A. John, (författare)
Imperial Coll, London, England
Heidbuchel, Hein, (författare)
Univ Hosp, Antwerp, Belgium;Antwerp Univ, Antwerp, Belgium;Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium
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Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm. Uppsala kliniska forskningscentrum (UCR). (creator_code:org_t)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för medicinska vetenskaper. Kardiologi. (creator_code:org_t)
Ingår i: Europace. - OXFORD UNIV PRESS. - 1099-5129 .- 1532-2092. ; 20:8, s. 1231-1242
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. The European Heart Rhythm Association (EHRA) set out to co-ordinate a unified way of informing physicians on the use of the different NOACs. A writing group identified 20 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The 20 topics are (i) eligibility for NOACs; (ii) practical start-up and follow-up scheme for patients on NOACs; (iii) ensuring adherence to prescribed oral anticoagulant intake; (iv) switching between anticoagulant regimens; (v) pharmacokinetics and drug drug interactions of NOACs; (vi) NOACs in patients with chronic kidney or advanced liver disease; (vii) how to measure the anticoagulant effect of NOACs; (viii) NOAC plasma level measurement rare indications, precautions, and potential pitfalls; (ix) how to deal with dosing errors; (x) what to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a potential risk of bleeding (xi) management of bleeding under NOAC therapy; (xii) patients undergoing a planned invasive procedure, surgery or ablation; (xiii) patients requiring an urgent surgical intervention; (xiv) patients with AF and coronary artery disease; (xv) avoiding confusion with NOAC dosing across indications; (xvi) cardioversion in a NOAC-treated patient; (xvii) AF patients presenting with acute stroke while on NOACs; (xviii) NOACs in special situations; (xix) anticoagulation in AF patients with a malignancy, and (xx) optimizing dose adjustments of VKA. Additional information and downloads of the text and anticoagulation cards in different languages can be found on an EHRA web site (www.NOACforAF.eu)


MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)


Non-vitamin K antagonist oral anticoagulants
Vitamin K antagonist
Atrial fibrillation

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