Despite known benefits, oral anticoagulation remains widely underused in high-risk AF patients, highlighting the need for better risk scores and user-friendly medications.
Persistent OAC underuse in high-risk AF warrants clinical vigilance; leaves open refinement of risk scores and simpler agents.
Atrial fibrillation (AF) is the most common sustained arrhythmia of the Western world. The increased ischemic stroke risk of the AF patient is one of the most important clinical issues to manage. Despite the well-known benefit of oral anticoagulation in high-risk AF patients, these drugs are widely underused in daily practice all over the world. We describe old and new paradigms of the use of oral anticoagulation. In the future, increased comprehensibility of stroke risk scores, development of a validated clinical bleed risk score, and new patient and physician user-friendly antithrombotic medication may contribute to improved adequate use of oral anticoagulation in AF patients.
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Pisters et al. (2009) studied this question.
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