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

Access to Document

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.",

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",

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

note = "{\textcopyright} 2019 Seelig et al.",

year = "2019",

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doi = "10.2147/VHRM.S187656",

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TY - JOUR

T1 - When to withhold oral anticoagulation in atrial fibrillation - an overview of frequent clinical discussion topics

AU - Seelig, Jaap

AU - Pisters, Ron

AU - Hemels, Martin E

AU - Huisman, Menno V

AU - Ten Cate, Hugo

AU - Alings, Marco

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

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.

KW - Age

KW - Anticoagulants

KW - Atrial fibrillation

KW - Frail elderly

KW - Hemorrhage

KW - Stroke/diagnosis

KW - Age Factors

KW - Risk Assessment

KW - Administration, Oral

KW - Humans

KW - Risk Factors

KW - Withholding Treatment

KW - Hemorrhage/chemically induced

KW - Patient Selection

KW - Anticoagulants/administration & dosage

KW - Clinical Decision-Making

KW - Atrial Fibrillation/diagnosis

KW - Health Status

KW - Frailty/epidemiology

KW - frail elderly

KW - atrial fibrillation

KW - anticoagulants

KW - age

KW - hemorrhage

UR - https://www.scopus.com/pages/publications/85072778050

U2 - 10.2147/VHRM.S187656

DO - 10.2147/VHRM.S187656

M3 - Review article

C2 - 31571891

SN - 1176-6344

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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