Oral anticoagulation in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1: a current opinion of the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy and European Society of Cardiology Council on Stroke-Reference-Cited by-同舟云学术

Oral anticoagulation in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1: a current opinion of the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy and European Society of Cardiology Council on Stroke

Published:2019-05-23 Issue:3 Volume:5 Page:171-180
ISSN:2055-6837
Container-title:European Heart Journal - Cardiovascular Pharmacotherapy
language:en
Short-container-title:

Author:

Sulzgruber Patrick¹^ORCID,Wassmann Sven²³,Semb Anne Grete⁴,Doehner Wolfram⁵⁶,Widimsky Petr⁷,Gremmel Thomas¹⁸,Kaski Juan Carlos⁹,Savarese Gianluigi¹⁰,Rosano Giuseppe M C¹¹,Borghi Claudio¹²,Kjeldsen Keld¹³¹⁴,Torp-Pedersen Christian¹⁵¹⁶,Schmidt Thomas Andersen¹⁷,Lewis Basil S¹⁸¹⁹^ORCID,Drexel Heinz²⁰²¹,Tamargo Juan²²,Atar Dan²³,Agewall Stefan²³,Niessner Alexander¹

Affiliation:

1. Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria

2. Cardiology Pasing, Institutstraße 14, 81241 Munich, Germany

3. University of the Saarland, Kirrberger Straße 100, 66424 Homburg, Saar, Germany

4. Department of Rheumatology, Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Diakonveien 12, 0370 Oslo, Norway

5. Department of Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK), Oudenarder Straße 16, 13316 Berlin, Germany

6. BIH Center for Regenerative Therapies (BCRT), Charité Universitaetsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany

7. Cardiocenter, Third Faculty of Medicine, Charles University, Opletalova 38, 110 00 Staré Město, Prague, Czech Republic

8. Department of Internal Medicine, Cardiology and Nephrology, Landesklinikum Wiener Neustadt, Corvinusring 3-5, 2700 Wiener Neustadt, Austria

9. Molecular and Clinical Sciences Research Institute, St George’s, University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK

10. Cardiology Division, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Eugeniavägen 3, 171 76 Solna, Stockholm, Sweden

11. Centre for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy

12. Atherosclerosis Research Unit, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi Hospital, University of Bologna, Via Zamboni, 33, 40126 Comune di Bologna BO, Italy

13. Department of Cardiology, Copenhagen University Hospital (Hvidovre-Amager), Blegdamsvej 9, 2100 Copenhagen, Denmark

14. Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark

15. Department of Health Sciences and Technology, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark

16. Department of Cardiology, Aalborg University Hospital, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark

17. Emergency Department, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark

18. Lady Davis Carmel Medical Center, Mikhal St 7, 3436212 Haifa, Israel

19. Technion-Israel Institute of Technology, Ruth and Bruce Rappaport School of Medicine, Efron St 1, 3436212 Haifa, Israel

20. VIVIT Research, Landeskrankenhaus Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria

21. Private University of the Principality of Liechtenstein, Dorfstrasse 24. FL-9495 Triesen, Principality of Liechtenstein

22. Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Avda. de Séneca, 2 Ciudad Universitaria, 28040 Madrid, Spain

23. Department of Cardiology, Oslo University Hospital and Institute of Clinical Medicine, Oslo University, Klaus Torgírds vei 3, 0372 Oslo, Norway

Abstract

Abstract Oral anticoagulation in patients presenting with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1 (CHA2DS2-VASc of 2 in women) remains a challenging approach in clinical practice. Therapeutic decisions need to balance the individual benefit of reducing thromboembolic risk against the potential harm due to an increase in bleeding risk in this intermediate risk patient population. Within the current opinion statement of the European Society of Cardiology working group of cardiovascular pharmacotherapy and the European Society of Cardiology council on stroke the currently available evidence on the anti-thrombotic management in patients presenting with a CHA2DS2-VASc of 1 is summarized. Easily applicable tools for a personalized refinement of the individual thromboembolic risk in patients with atrial fibrillation and a CHA2DS2-VASc score of 1 that guide clinicians through the question whether to anticoagulate or not are provided.

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Cardiology and Cardiovascular Medicine

Link

http://academic.oup.com/ehjcvp/advance-article-pdf/doi/10.1093/ehjcvp/pvz016/28789522/pvz016.pdf

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