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Semin Thromb Hemost 2009; 35(6): 554-559
DOI: 10.1055/s-0029-1241048
© Thieme Medical Publishers

Use and Underuse of Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation: Old and New Paradigms

Ron Pisters1 , Cees B. de Vos1 , Robby Nieuwlaat1 , Harry J. G. M Crijns1
  • 1Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Publication History

Publication Date:
28 September 2009 (online)

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ABSTRACT

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.

KEYWORDS

Atrial fibrillation - oral anticoagulation - stroke prevention

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Ron Pisters

Department of Cardiology, Maastricht University Medical Centre

PO Box 5800, 6202 AZ Maastricht, The Netherlands

Email: r.pisters@mumc.nl