Macau Cardiology Association

News

ESC Congress Barcelona 2017
August 26 – 30, Spain

8th Asia Pacific Congenital & Structural Heart Intervention Symposium 2017
October 7 – 8, Hong Kong Convention & Exhibition Centre

Macau Cardiology Association - 2017 Annual General Assembly
December 8 – 10, Macau

Guidelines/Surveys/Experts' Advice

American Heart Association
Scientific Statements and Practice Guidelines Topic List

 

European Society of Cardiology
ESC Clinical Practice Guidelines List

 

Experts' Advice
Stroke prevention in atrial fibrillation: An Asian perspective

Summary

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. In 2050, it is estimated that there will be 72 million AF patients in Asia, accounting for almost 2.9 million patients suffering from AF-associated stroke. Asian AF patients share similar risk factor profiles as non-Asians, except that more Asians have a history of previous stroke. Clinical challenges are evident in the field of stroke prevention in AF, amongst Asians. Existing stroke and bleeding risk scores have not been well-validated in Asians. Asians are prone to bleeding when treated with warfarin, and the optimal international normalized ratio (INR) for warfarin use is yet to be determined in Asians, though Asian physicians tend to keep it in a lower range (e.g. INR 1.6–2.6) for elderly patients despite limited evidence to justify this. In general, warfarin is ‘difficult’ to use in Asians due to higher risk of bleeding and higher stroke rate in Asians than in non-Asians, as shown in randomized controlled trials. Excess of bleeding was not found in Asians when novel oral anticoagulants (NOACs) were used. Besides, the superiority of NOACs to warfarin in reducing thromboembolism was maintained in Asians. Therefore NOACs are preferentially indicated in Asians in terms of both efficacy and safety. Also, some preliminary data suggest that Asian patients with AF might not be the same. Future prospective randomized trials are needed for the selection of NOACs according to different ethnic background.

 

 

For more details, please visit Thrombosis and Haemostasis 111.5/2014

 

www.thrombosis-online.com on 2014-02-21

 

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