Semin Thromb Hemost 2009; 35(6): 527-542
DOI: 10.1055/s-0029-1240013
© Thieme Medical Publishers

Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and Perspectives

Marcel Levi1 , F. D. Richard Hobbs2 , Alan K. Jacobson3 , Ron Pisters4 , Domenico Prisco5 , Artur Bernardo6 , Markus Haas7 , Jens Heidrich8 , Matt Rosenberg9 , Jørn Dalsgaard Nielsen10 , Walter A. Wuillemin11
  • 1Department of Vascular Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  • 2Primary Care Clinical Sciences, University of Birmingham, UK
  • 3Loma Linda University School of Medicine, Department of Anticoagulation Services, Cardiology Section, Loma Linda VA Medical Center, Loma Linda, CA, USA
  • 4Department of Cardiology, University Hospital of Maastricht, The Netherlands
  • 5Department of Medical and Surgical Critical Care, Thrombosis Centre, University Hospital Careggi, Florence, Italy
  • 6Department of Cardiology, Klinik Gais, Gais, Switzerland
  • 7Theresienkrankenhaus, Academic Hospital, Mannheim, Germany
  • 8Laboratory Dr. von Froreich & Kollegen GmbH, Hamburg, Germany
  • 9General Practitioner, Jackson, Michigan, USA
  • 10Thrombosis Centre, Gentofte Hospital, Hellerup, Denmark
  • 11Division of Haematology, Luzerner Kantonsspital and University of Bern, Switzerland
Further Information

Publication History

Publication Date:
28 September 2009 (online)

ABSTRACT

Despite overwhelming evidence of the benefits of risk-adjusted oral anticoagulation on stroke reduction in patients with atrial fibrillation (AF), there is still considerable undertreatment. A multidisciplinary expert group was formed to discuss issues surrounding anticoagulant treatment of patients with AF to try and achieve consensus on various aspects of the implementation of guidelines on oral anticoagulation therapy in AF. Panel members were cardiologists, hematologists, and laboratory and primary care physicians with specific expertise from Europe and the United States. One of the most important conclusions of the meeting was to enhance guideline adherence by better communication of the data showing that the benefits of stroke reduction outweigh the risk of bleeding associated with treatment with vitamin K antagonists. Management of oral anticoagulation therapy by dedicated centers, such as anticoagulation clinics, or by patient self-management may improve the quality of anticoagulation and facilitate the management of these patients and thereby further facilitate optimal antithrombotic management in patients with AF.

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Marcel LeviM.D. 

Department Internal Medicine, Academic Medical Centre F-4

Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Email: m.m.levi@amc.uva.nl