Hear what our experts Professors Rob Storey and Renato Lopes think about the current guidelines in these videos:
Professor Lopes: What are your views on the current Guidelines?
Professor Lopes describes the lack of studies which have previously resulted in recommendations based on limited evidence. The hope is that now that there are four trials in the field of atrial fibrillation and acute coronary syndrome and a meta-analysis there is more strength of evidence for the guidelines committees to consider.
The individualisation of therapy is really important, but it seems that there it seems that there is a slight difference between the American and European guidelines – do you feel this is a big issue?
Professor Storey looks ahead to ongoing studies which are likely to result in convergence of the ESC and US position in terms of dual versus triple therapy immediately after PCI. Find out how recent guideline updates are moving us to geographical alignment on treatment recommendations.
With the harmonisation of the American and ESC guidelines in your opinion how important is this for improving patient treatment outcomes?
Find out why harmonisation of the American and ESC guidelines builds clinician confidence. Professor Storey explains how dialogue between different groups helps to build consensus and builds global confidence.
The other sections in the Learning Zone summarise the evidence that AF is common, an important cause of stroke and that most AF patients should receive anticoagulants.5 Emerging evidence also suggests that DOAC could have an important role in stroke prevention in people presenting with acute coronary syndrome (ACS), including those undergoing percutaneous coronary intervention (PCI). This section summarises the latest guidance from Europe and the USA regarding the use of anticoagulants to prevent stroke and systemic embolism in patients with AF.5,37
European Society of Cardiology (ESC) and the European Heart Rhythm Association (EHRA) guidelines
Update your knowledge of the European guidelines regarding the use of oral anticoagulants to prevent thromboembolism in AF patients.
The ESC/EHRA guidelines recommend oral anticoagulants to prevent thromboembolism for all male AF patients with a CHA2DS2-VASc score of 2 or more and all female patients with a CHA2DS2-VASc score of 3 or more.
American College of Cardiology (ACC), American Heart Association (AHA) and Heart Rhythm Society (HRS) guidelines
Update your knowledge of the American recommendations regarding the use of oral anticoagulants to prevent thromboembolism in AF patients.
The guidelines from the USA recommend oral anticoagulants for AF (or atrial flutter) patients with a CHA2DS2-VASc score of two or greater in men or three or greater in women.
Unless, the person has moderate-to-severe mitral stenosis or a mechanical heart valve, the guidelines remark that omitting anticoagulants is reasonable for AF patients CHA2DS2-VASc score of zero in men or one in women, but can be considered in those with scores of one and two respectively.37
References for Anticoagulation Therapy for Stroke Prevention
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