ESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
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ESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
Europace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocIDEUpdated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillationHein Heidbuchel1*, Peter Verhamme2, Marco Alings3, Matthias Antz4, Hans-Christoph Diener5, Werner Hacke6, Jonas Oldgren7, Peter Sinnaeve ESC EHRA AF novel AC NOAC 2015 khotailieu y hoc2, A. John Camm8, and Paulus Kirchhoff*10Advisors:, Azhar Ahmad, M.D. (Boehringer Ingelheim Pharma), Jutta Heinrich-Nols, M.D. (Boehringer Ingelheim PESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
harma), Susanne Hess, M.D. (Bayer Healthcare Pharmaceuticals), Markus Muller, M.D., Ph.D. (Pfizer Pharma), Felix Miinzel, Ph.D. (Daiichi-Sankyo EuropeEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hoc (Bristol Myers Squibb/Pfizer)Document reviewers:, Gregory Y.H. Lip, (Reviewer Coordinator; UK),Chern-En Chiang, (Taiwan), Jonathan Piccini, (USA), Tatjana Potpara, (Serbia), Laurent Fauchier, (France), Deirdre Lane, (UK), Alvaro Avezum, (Brazil), Torben Bjerregaard Larsen, (Denmark), Guiseppe Boria ESC EHRA AF novel AC NOAC 2015 khotailieu y hocni, (Italy),Vanessa Roldan-Schilling, (Spain), Bulent Gorenek, (Turkey), and Irene Savelieva, (UK, on behalf of EP-Europace)'l>Ị|MrtnHỊiil cal Ortft JESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
iacy Altli^hrtx+ >xy. How'll I>■ varsity uihIHimiI Cavil ar.JmM Hinpiul.St/whixrrzMtl 11. tsooH.wll. Ra-I^iimi,^fJa'iMrlinrnl flicSciạTXKx Unraerscy oEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocartment of Neurology. University I tospital Essen. University Duobj-g Esser, Gsrminy ’Department of Neurology. Ruprecht Karts Uri.ersitat I lefdelbcrg. Germany. 'Uppsala Cliikal Rrwurrh Cratfav uiwl ISrtMTitrarW erf Mixl«*l Sfiriiirv, Uppwlft O'iwrvjiy. IẠỉịsmU. Swffeii; aClí'írul Cfitliirfis;/. Si ESC EHRA AF novel AC NOAC 2015 khotailieu y hocGmtyyS lArfvrnily. IihhIixx UK. Alnnviwly irf Rkfriiijjwn Cụvnrv forESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
ựy.University of M&vatur, GtrarwifgThe current manuscript is an update of the original Practical Guide, published in June 2O13[Heidbuchel H, Vcrhammc Europace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocth non-valvular atrial fibrillation. Fijrppcxr 2013:15:625 51; Hádbuchd H, Verhammc p. Alings M. Antz M. Hacke w. Oldgrcn J, et ol. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart j 2013:34:2094 -106]. Non-vit ESC EHRA AF novel AC NOAC 2015 khotailieu y hocamm K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atriaESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
l fibrillation (AF). Both physicians and patients have to learn how to use these drugs effectively and safely in clinical practice. Many unresolved quEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocied way of informing physicians on the use of the different NOACs. A writing group defined what needs to be considered as 'non-vatvular AF and listed 15 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The 15 topics are (i) practical sta ESC EHRA AF novel AC NOAC 2015 khotailieu y hocrt-up and follow-up scheme for patients on NOACs; (ii) how to measure the anticoagulant effect ofoiarui.ir .iukO.i !»•! into .-13* Corrtopondric authoESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
r Tot I 32 11 50 95 75; face; +32 11 30 78 39. E-nx»1 o-.Ww heinhekJtxKhellXjt'wizh.bc. hcnhcki^pTnf.comPublished on behalf of me Eurcpcir Society of Europace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hoctions and pharmacokinetics of NOACs; (iv) switching between anticoagulant regimens: (v) ensuring adherence of NOAC intake; (vi) how to deal with dosing errors: (vii) patients with chronic kidney disease; (viii) what to do if there is a (suspected) overdose without bleeding, or a clotting test is ind ESC EHRA AF novel AC NOAC 2015 khotailieu y hocicating a risk of bleeding?; (xi) management of bleeding complications; (x) patients undergoing a planned surgical intervention or ablation; (xi) patiESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
ents undergoing an urgent surgical intervention; (xli) patients with AF and coronary artery disease: (xiii) cardioversion in a NOAC-trcatcd patient: (Europace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocads of the text and anticoagulation cards in > 16 languages can be found on an European Heart Rhythm Assooation web site (www.NOACforAF.eu).Keywords Atrial fibrillation • Anticoagulation • Stroke • Bleeding • Pharmacology • Non-VKA oral anticoagulants • NOACIntroductionNon-vitamin K antagonist (VKA) ESC EHRA AF novel AC NOAC 2015 khotailieu y hoc oral anticoagulants (NOACs)1' have emerged as an alternative to VKAs for thrombo embolic pre vention in patients with non-vatvular atrial fibrillatioESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
n (Al). Some authors refer to these drugs as ‘direct oral anticoagulants' (DOACs),3 but since the term NOAC. lias been used for many years and is wideEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocfei.t without need for routine monitoring, and fewer food and drug interactions compared with VKAs. However. the proper use of NOACs requires different approaches to many prac tical aspects c ompared with VKAs. Whereas the FSC. Guidelines’ '■ mainly discuss the indications for anticoagulation in gen ESC EHRA AF novel AC NOAC 2015 khotailieu y hoceral (e.g. based CXI the CHA,OS, VASc score) and of NOAGs ill particular, they offer less guxlance on how Io deal with NOAGs in specific clinical situESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
ations. Moreover, there arc still underexplored as|>ec ts of NOAG use dial is relevant when these drugs arc used by cardiologists, neurologists, geriaEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocl úlua tions [summary of product characteristics (SmPCs); patient card: information leaflets for patients and physicians], but multiple, and often slightly different, physician education tcxils sexnetimes create confusion rather than clarity. Based on these premises, the European Heart Rhythm Associ ESC EHRA AF novel AC NOAC 2015 khotailieu y hocation (EHRA) set out to coordrate a unified way of informing physicians on the use of NOAGs. A first Practical Guide was published in 2013 to supplemeESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
nt the AF guidelines as a guidance for safe, effective use of NOAG when prescribed.*'7 Tlws text is a first update Io the original Guide.A writing groEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocfrom the companies that bring NOACs to the market they provided assurance that the latest information on the different NOAGs was evaluated, and provided feedback on the alignment of the text with the approved SmPCs. However, the responsibility of this document resides entirely with the EHRA writing ESC EHRA AF novel AC NOAC 2015 khotailieu y hocgroup. In some instances, the authors opted to make recommendations that do not fully align With all SmPC, with the goal to provide more uniform and sESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
imple practical advice (e.g. on the start of NOAC after cessation of VKA; on advice after a missed or forgotten dose). An EHRA website. www.NOACforAF.Europace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hoche items that have been dunged from the original version.I he Practical Guide is summarized in a Key Message booklet which can be obtained through EHRA and ESG. Please lune in to the www.NOACforAF.eu website for related information. The website also provides EHRA members with a downloadable slide ki ESC EHRA AF novel AC NOAC 2015 khotailieu y hoct on the Practical Guide.We hope dial this collaborative effort lus yielded the practical tool that EHRA envisioned and that it has become even betterESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
with this revision. The authors realize that there will be gaps, unaddressed questions, and many areas of unccrtainty/dcbatc. I hcrcforc. readers canEuropace Advance Access published August 31, 2 ttps;//khothuvie .comCUffOPCANỊQCtt IV tAíủOííX.**Europaccdoi:10.1093/europace/euv309EHRA PRACTICAL GUI ESC EHRA AF novel AC NOAC 2015 khotailieu y hocon of *non-valvular atrial fibrillation* and eligibility for non-vitamin K antagonist oral anticoagulantsNon-valvular AF refers to AF that occurs in the absence of mechanical prosthetic heart valves and in the absence of moderate to severe mitral stenosis (usually of rheumatic cxigin) (Table f). Bot ESC EHRA AF novel AC NOAC 2015 khotailieu y hoch tyjxts of patients were excluded from all NOAC trials. Atrial fibrillation in patients with other valvular ịxxiblerns is defined as "non valvular" aESC EHRA AF novel AC NOAC 2015 khotailieu y hoc
nd such patients were included in the trials. Atrial fibrillation in patients with biological valves or after valve repair constitute a grey area, andGọi ngay
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