When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics

Jaap Seelig; Ron Pisters; Martin E Hemels; Menno V Huisman; Hugo Ten Cate; Marco Alings

doi:10.2147/VHRM.S187656

When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics

Jaap Seelig, Ron Pisters, Martin E Hemels, Menno V Huisman, Hugo Ten Cate, Marco Alings

Research output: Contribution to journal › Review article › peer-review

Abstract

Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach. To guide clinical decision-making, we have reviewed available evidence on the most frequently reported reasons for withholding anticoagulation: previous bleeding, frailty and age, and an overall high bleeding risk.

Original language	English
Pages (from-to)	399-408
Number of pages	10
Journal	Vascular Health and Risk Management
Volume	15
DOIs	https://doi.org/10.2147/VHRM.S187656
Publication status	Published - 1 Jan 2019
Externally published	Yes

Keywords

Age
Anticoagulants
Atrial fibrillation
Frail elderly
Hemorrhage
Stroke/diagnosis
Age Factors
Risk Assessment
Administration, Oral
Humans
Risk Factors
Withholding Treatment
Hemorrhage/chemically induced
Patient Selection
Anticoagulants/administration & dosage
Clinical Decision-Making
Atrial Fibrillation/diagnosis
Health Status
Frailty/epidemiology
frail elderly
atrial fibrillation
anticoagulants
age
hemorrhage

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10.2147/VHRM.S187656

Cite this

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title = "When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics",

abstract = "Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach. To guide clinical decision-making, we have reviewed available evidence on the most frequently reported reasons for withholding anticoagulation: previous bleeding, frailty and age, and an overall high bleeding risk.",

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author = "Jaap Seelig and Ron Pisters and Hemels, {Martin E} and Huisman, {Menno V} and {Ten Cate}, Hugo and Marco Alings",

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AU - Pisters, Ron

AU - Hemels, Martin E

AU - Huisman, Menno V

AU - Ten Cate, Hugo

AU - Alings, Marco

PY - 2019/1/1

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AB - Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach. To guide clinical decision-making, we have reviewed available evidence on the most frequently reported reasons for withholding anticoagulation: previous bleeding, frailty and age, and an overall high bleeding risk.

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KW - Anticoagulants

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KW - Frail elderly

KW - Hemorrhage

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KW - Age Factors

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KW - Risk Factors

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KW - Clinical Decision-Making

KW - Atrial Fibrillation/diagnosis

KW - Health Status

KW - Frailty/epidemiology

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KW - atrial fibrillation

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VL - 15

SP - 399

EP - 408

JO - Vascular Health and Risk Management

JF - Vascular Health and Risk Management

ER -

When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics

Abstract

Keywords

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