Key result
Atrial fibrillation is a systemic vascular disease requiring holistic vascular protection beyond oral anticoagulation.
Why the study?
AF cannot be considered an isolated disease, and patients should be managed using a comprehensive approach not limited to stroke prevention.
Should atrial fibrillation be managed with a comprehensive vascular approach rather than just stroke prevention?
Should atrial fibrillation be managed with a comprehensive vascular approach rather than just stroke prevention?
Atrial fibrillation should be viewed as a systemic vascular disease requiring holistic management beyond just oral anticoagulation.
Supports holistic vascular strategies in AF beyond OAC; leaves open need for prospective trials before practice change.
INTRODUCTION: Atrial fibrillation (AF) cannot be considered an isolated disease. Patients with AF should be managed using a comprehensive approach that is not limited to stroke prevention. AREAS COVERED: In this manuscript, the potential role of AF as a vascular disease that is managed as part of a holistic approach was reviewed. EXPERT OPINION: The residual risk of stroke in patients with AF reaches 1-2% annually, despite appropriate anticoagulation therapy. Additionally, patients with AF may develop cognitive impairment through stroke-independent pathways. Furthermore, patients with AF may have a higher risk of developing atherosclerotic vascular disease in various vascular beds and chronic kidney disease; conversely, patients with atherosclerotic disease may have an increased risk of developing AF. AF should be considered a truly systemic vascular disease, since it brings together several hemodynamic and systemic changes, including inflammation, oxidative stress, activation of the renin-angiotensin-aldosterone and sympathetic systems, as well as a prothrombotic state and endothelial dysfunction. In this regard, patients with AF should be treated based on a holistic approach that is not limited to oral anticoagulation but includes complete vascular protection.
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Escobar-Cervantes et al. (2023) conducted a review in Atrial fibrillation. Holistic vascular approach was evaluated. Atrial fibrillation should be considered a systemic vascular disease requiring a holistic management approach that includes complete vascular protection beyond oral anticoagulation.
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