Stroke Prevention in Atrial Fibrillation: A Scientific Statement of JACC: Asia (Part 2)

JACC Asia. 2022 Aug 23;2(5):519-537. doi: 10.1016/j.jacasi.2022.06.004. eCollection 2022 Oct.

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with substantial increases in the risk for stroke and systemic thromboembolism. With the successful introduction of the first non-vitamin K antagonistdirect oral anticoagulant agent (NOAC) in 2009, the role of vitamin K antagonists has been replaced in most clinical settings except in a few conditions for which NOACs are contraindicated. Data for the use of NOACs in different clinical scenarios have been accumulating in the past decade, and a more sophisticated strategy for patients with AF is now warranted. JACC: Asia recently appointed a working group to summarize the most updated information regarding stroke prevention in AF. The aim of this statement is to provide possible treatment options in daily practice. Local availability, cost, and patient comorbidities should also be considered. Final decisions may still need to be individualized and based on clinicians' discretion. This is part 2 of the statement.

Keywords: AF, atrial fibrillation; Asia; CKD, chronic kidney disease; CrCl, creatinine clearance; ESRD, end-stage renal disease; LAA, left atrial appendage; NOAC; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant; VKA; VKA, vitamin K antagonist; atrial fibrillation; eGFR, estimated glomerular filtration rate; stroke.

Publication types

  • Review