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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24367

Title: Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary
Authors: Heidbuchel, Hein
Verhamme, Peter
Alings, Marco
Antz, Matthias
Diener, Hans-Christoph
Hacke, Werner
Oldgren, Jonas
Sinnaeve, Peter
Camm, A. John
Kirchhof, Paulus
Issue Date: 2017
Publisher: OXFORD UNIV PRESS
Citation: EUROPEAN HEART JOURNAL, 38(27), p. 2137-2149
Abstract: In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for acute management of coronary interventions, step-down schemes for long-term combined antiplatelet-anticoagulant management in coronary heart disease, management of bleeding, and cardioversion under NOAC therapy. The Updated Guide is available in full in EP Europace (Heidbuchel H, Verhamme P, Alings M, Antz M, Diener HC, HackeW, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, Advisors. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507), while additional resources can be found at the related ESC/EHRA website (www.NOACforAF.eu).
Notes: [Heidbuchel, Hein] Hasselt Univ & Heart Ctr, Stadsomvaart 11, B-3500 Hasselt, Belgium. [Verhamme, Peter; Sinnaeve, Peter] Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium. [Alings, Marco] Amphia Ziekenhuis, Dept Cardiol, Breda, Netherlands. [Antz, Matthias] Klinikum Oldenburg, Dept Cardiol, Oldenburg, Germany. [Diener, Hans-Christoph] Univ Duisburg Essen, Univ Hosp Essen, Dept Neurol, Essen, Germany. [Hacke, Werner] Ruprecht Karls Univ Heidelberg, Dept Neurol, Heidelberg, Germany. [Oldgren, Jonas] Uppsala Univ, Dept Med Sci, Uppsala Clin Res Ctr, Uppsala, Sweden. [Camm, A. John] St Georges Univ, Clin Cardiol, London, England. [Kirchhof, Paulus] Univ Birmingham, Ctr Cardiovasc Sci, Birmingham, W Midlands, England. [Kirchhof, Paulus] Univ Munster, Dept Cardiol & Angiol, Munster, Germany.
URI: http://hdl.handle.net/1942/24367
DOI: 10.1093/eurheartj/ehw058
ISI #: 000405499800015
ISSN: 0195-668X
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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