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Complex clinical scenarios with the use of direct oral anticoagulants in patients with atrial fibrillation: a multidisciplinary expert advisory board

Mulder, B. A., Ten Berg, J., Ten Cate, H., van Es, N., Hemels, M. E. W., Kappelle, L. J., Bearda Bakker, H. B., de Borst, G. J., Drenth, D. J., Geersing, G. J. & Rienstra, M., 11-May-2020, In : Netherlands Heart Hournal. 28, 10, p. 504-513 8 p.

Research output: Contribution to journalReview articleAcademicpeer-review

  • B A Mulder
  • J Ten Berg
  • H Ten Cate
  • N van Es
  • M E W Hemels
  • L J Kappelle
  • H B Bearda Bakker
  • G J de Borst
  • D J Drenth
  • G J Geersing
  • M Rienstra

The risk of developing atrial fibrillation (AF) and the risk of stroke both increase with advancing age. As such, many individuals have, or will develop, an indication for oral anticoagulation to reduce the risk of stroke. Currently, a large number of anticoagulants are available, including vitamin K antagonists, direct thrombin or factor Xa inhibitors (the last two also referred to as direct oral anticoagulants or DOACs), and different dosages are available. Of the DOACs, rivaroxaban can be obtained in the most different doses: 2.5mg, 5mg, 15mg and 20mg. Many patients develop co-morbidities and/or undergo procedures that may require the temporary combination of anticoagulation with antiplatelet therapy. In daily practice, clinicians encounter complex scenarios that are not always described in the treatment guidelines, and clear recommendations are lacking. Here, we report the outcomes of a multidisciplinary advisory board meeting, held in Utrecht (The Netherlands) on 3 June 2019, on decision making in complex clinical situations regarding the use of DOACs. The advisory board consisted of Dutch cardiovascular specialists: (interventional) cardiologist, internist, neurologist, vascular surgeon and general practitioners invited according to personal title and specific field of expertise.

Original languageEnglish
Pages (from-to)504-513
Number of pages8
JournalNetherlands Heart Hournal
Volume28
Issue number10
Early online date2020
Publication statusPublished - 11-May-2020

    Keywords

  • Atrial fibrillation, Co-morbidities, Anticoagulation, Stroke prevention, Direct oral anticoagulant, PERCUTANEOUS CORONARY INTERVENTION, ANTITHROMBOTIC THERAPY, EUROPEAN-SOCIETY, RIVAROXABAN, PREVENTION, MANAGEMENT, WARFARIN, STROKE, THROMBOEMBOLISM, METAANALYSIS

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