Stroke prevention in atrial fibrillation: Past, present and future

Gregory Y.H. Lip; Ben Freedman; Raffaele De Caterina; Tatjana S. Potpara

doi:10.1160/TH16-11-0876

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2017; 117(07): 1230-1239
DOI: 10.1160/TH16-11-0876

60th Anniversary

Schattauer GmbH

Stroke prevention in atrial fibrillation: Past, present and future

Comparing the guidelines and practical decision-making

Gregory Y.H. Lip

¹Institute of Cardiovascular Science, University of Birmingham, Birmingham, UK

²Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

³School of Medicine, Belgrade University, Belgrade, Serbia

,

Ben Freedman

⁴Heart Research Institute, Charles Perkins Centre, Sydney Medical School, University of Sydney, Sydney, Australia

⁵Department of Cardiology and Anzac Research Institute, Concord Hospital, University of Sydney, Australia

,

Raffaele De Caterina

⁶G. d’Annunzio” University and Center of Excellence on Aging – CeSI-Met, Chieti, Italy

,

Tatjana S. Potpara

³School of Medicine, Belgrade University, Belgrade, Serbia

⁷Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia

› Author Affiliations

Abstract

Summary

Concepts and our approaches to stroke prevention in atrial fibrillation (AF) have changed markedly over the last decade. There has been an evolution over the approach to stroke and bleeding risk assessment, as well as new treatment options. An increasing awareness of AF has led to calls to improve the detection of and population screening for AF. Stroke and bleeding risk assessment continues to evolve, and the ongoing debate on balance between simplicity and practicality, against precision medicine will continue. In this review article, we provide an overview of past, present and the (likely) future concepts and approaches to stroke prevention in AF. We propose three simple steps (the Birmingham ‘3-step’) that offers a practical management pathway to help streamline and simplify decision-making for stroke prevention in patients with AF.

Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.

Keywords

Atrial fibrillation - stroke prevention - non-vitamin K antagonist oral anticoagulants - warfarin

Full Text

References

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