Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report

Chest
Gregory Y H LipLisa Moores

Abstract

The risk of stroke is heterogeneous across different groups of patients with atrial fibrillation (AF), being dependent on the presence of various stroke risk factors. We provide recommendations for antithrombotic treatment based on net clinical benefit for patients with AF at varying levels of stroke risk and in a number of common clinical scenarios. Systematic literature reviews were conducted to identify relevant articles published from the last formal search perfomed for the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (9th Edition). The overall quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted, voted on, and revised until consensus was reached. For patients with AF without valvular heart disease, including those with paroxysmal AF, who are at low risk of stroke (eg, CHA2DS2-VASc [congestive heart failure, hypertension, age ≥ 75 (doubled), diabetes, stroke (doubled)-vascular disease, age 65-74 and sex category (female)] score of 0 in males or 1 in females), we suggest no antithrombotic therapy...Continue Reading

Citations

Oct 20, 2018·International Journal of Clinical Practice·Gregory Y H Lip
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Jan 19, 2019·Liver International : Official Journal of the International Association for the Study of the Liver·Alessandro MantovaniGiovanni Targher
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May 22, 2019·Journal of the American Geriatrics Society·Steven DeitelzweigGregory Y H Lip
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Jun 19, 2019·Stroke; a Journal of Cerebral Circulation·So-Ryoung LeeGregory Y H Lip
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Jul 30, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Zbigniew KalarusSergio Berti
Jul 30, 2019·European Heart Journal Cardiovascular Imaging·Alena ShantsilaGregory Y H Lip
Jul 31, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·John B Bossaer, Kelly L Covert
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Dec 27, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Victoria M StevensTyree H Kiser
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Sep 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michael GliksonUNKNOWN ESC Scientific Document Group
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Apr 16, 2020·Journal of Pharmacy Practice·Tara A NagarajMuhammad Afzal

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