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December 8, 2016Advances in TherapyOpen Access

Decision-Making in Clinical Practice: Oral Anticoagulant Therapy in Patients with Non-valvular Atrial Fibrillation and a Single Additional Stroke Risk Factor

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Key result

Oral anticoagulant therapy in patients with non-valvular atrial fibrillation and a single additional stroke risk factor reduces the risk of stroke, systemic embolism, or death compared to no therapy or aspirin.

Why the study?

Does oral anticoagulant therapy reduce stroke, systemic embolism, or death in patients with non-valvular atrial fibrillation and a single additional stroke risk factor?

Population

Patients with non-valvular atrial fibrillation and a single additional stroke risk factor.

Comparison

Oral anticoagulant therapy vs No therapy or aspirin

Design

Review

Authors

TPTatjana PotparaNDNikolaos DagresNMNebojša Mujović

Discussion

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Overview

Supports net clinical benefit of OAC in NVAF with one risk factor; leaves open practice change pending randomized confirmation.

Structured PICO

Does oral anticoagulant therapy reduce stroke, systemic embolism, or death in patients with non-valvular atrial fibrillation and a single additional stroke risk factor?

P
Population
Patients with non-valvular atrial fibrillation and a single additional stroke risk factor (e.g., CHA2DS2-VASc score of 1 for men or 2 for women).
I
Intervention
Oral anticoagulant therapy (vitamin K antagonists or non-vitamin K antagonist oral anticoagulants)
C
Comparator
No therapy or aspirin
O
Outcome
Composite of stroke, systemic embolism, or deathcomposite

Oral anticoagulant therapy provides a positive net clinical benefit in atrial fibrillation patients with a single additional stroke risk factor, supporting its use over aspirin or no therapy.

Limitations

  • Considerable heterogeneity among the reviewed observational studies
  • Variable methodology, anticoagulation status, and outcome definitions across different cohorts
  • Potential selection bias in some registry-based studies, such as conditioning on the future

Cite This Study

Potpara et al. (2016) conducted a review in Non-valvular Atrial Fibrillation. Oral Anticoagulant Therapy (OAC) vs. No therapy or aspirin was evaluated. Oral anticoagulant therapy in patients with non-valvular atrial fibrillation and a single additional stroke risk factor reduces the risk of stroke, systemic embolism, or death compared to no therapy or aspirin.

synapsesocial.com/papers/6a16331ff9339c53aa8e994fhttps://doi.org/10.1007/s12325-016-0458-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naive atrial fibrillation patients: Danish nationwide descriptive data 2011-20132014 · 165 citations
  2. 2Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation2007 · 4,828 citations
  3. 3Ischemic Stroke Risk in Patients With Atrial Fibrillation and CHA <sub>2</sub> DS <sub>2</sub> -VASc Score of 12016 · 105 citations
  4. 4Biomarkers in atrial fibrillation: a clinical review2013 · 299 citations
  5. 5Comparative Performance of ATRIA, CHADS2, and CHA2DS2-VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation2015 · 213 citations