Key result
Optimizing thromboprophylaxis in HF and AF requires integrating frailty, cognition, and adherence into stroke risk tools.
This review highlights the importance of individualized risk assessment, including frailty and adherence barriers, when prescribing thromboprophylaxis for patients with heart failure and atrial fibrillation.
May support incorporating frailty and adherence into HF-AF thromboprophylaxis decisions; leaves open prospective validation of integrated tools.
Atrial fibrillation is a common arrhythmia in heart failure and a risk factor for stroke. Risk assessment tools can assist clinicians with decision making in the allocation of thromboprophylaxis. This review provides an overview of current validated risk assessment tools for atrial fibrillation and emphasizes the importance of tailoring individual risk and the importance of weighing the benefits of treatment. Further, this review provides details of innovative and patient-centered methods for ensuring optimal adherence to prescribed therapy. Prior to initiating oral anticoagulant therapy, a comprehensive risk assessment should include evaluation of associated cardiogeriatric conditions, potential for adherence to prescribed therapy, frailty, and functional and cognitive ability.
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Ferguson et al. (2013) conducted a review in Heart failure and atrial fibrillation. Thromboprophylaxis and risk assessment tools was evaluated. Comprehensive risk assessment for thromboprophylaxis in heart failure and atrial fibrillation must incorporate frailty, cognitive function, and adherence potential alongside traditional stroke risk tools.
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