Antithrombotic management of patients with atrial fibrillation-Dutch anticoagulant initiatives anno 2020
Chu, G; Seelig, J; Trinks-Roerdink, E M; Geersing, G J; Rutten, F H; de Groot, J R; Huisman, M V; Hemels, M E W
(2020) Netherlands Heart Journal, volume 28, issue Suppl 1, pp. 19 - 24
(Article)
Abstract
In recent years, as more and more experience has been gained with prescribing direct oral anticoagulants (DOACs), new research initiatives have emerged in the Netherlands to improve the safety and appropriateness of DOAC treatment for stroke prevention in patients with atrial fibrillation (AF). These initiatives address several contemporary unresolved issues,
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such as inappropriate dosing, non-adherence and the long-term management of DOAC treatment. Dutch initiatives have also contributed to the development and improvement of risk prediction models. Although fewer bleeding complications (notably intracranial bleeding) are in general seen with DOACs in comparison with vitamin K antagonists, to successfully identify patients with high bleeding risk and to tailor anticoagulant treatment accordingly to mitigate this increased bleeding risk, is one of the research aims of recent and future years. This review highlights contributions from the Netherlands that aim to address these unresolved issues regarding the anticoagulant management in AF in daily practice, and provides a narrative overview of contemporary stroke and bleeding risk assessment strategies.
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Keywords: Adherence, Anticoagulation, Atrial fibrillation, Integrated care, Registry, Stroke and bleeding risk, Cardiology and Cardiovascular Medicine, Review, Journal Article
ISSN: 1568-5888
Publisher: Bohn Stafleu van Loghum
Note: Funding Information: G. Chu is supported by a research grant of ZonMW (project numbers 848050006 and 848050007). J. Seelig is supported by a grant from the Dutch Federation of Anticoagulation Clinics (FNT). E.M. Trinks-Roerdink reports no conflicts of interests. G. J. Geersing and F. H. Rutten received unrestricted institutional grants from Bayer, BMS/Pfizer, Boehringer Ingelheim, Daiichi Sankyo. J. R. de Groot received research grants (through institution) from Abbot, Atricure, Bayer, Boston Scientific, Medtronic. Received speaker/consultancy fees from Atricure, Bayer, Daiichi Sankyo, Johnson&Johnson, Medtronic, Novartis, Servier. Ownership: RhythmCARE. M. V. Huisman reports unrestricted grants from and personal fees from ZONMW, Boehringer Ingelheim, Pfizer/BMS, Bayer Health Care, Aspen, Daiichi Sankyo, outside the submitted work. M. E. W. Hemels received consultancy fees from Bayer, BMS/Pfizer, Boehringer Ingelheim, Daiichi Sankyo, Roche and received a research grant from Federation of Dutch Thrombosis Services. Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
(Peer reviewed)