Stroke Prevention in Atrial Fibrillation: A Scientific Statement of JACC: Asia (Part 1)

JACC Asia. 2022 Aug 16;2(4):395-411. doi: 10.1016/j.jacasi.2022.05.005. eCollection 2022 Aug.

Abstract

Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with substantial increases in the risk of stroke and systemic thromboembolism. With the successful introduction of the first non-vitamin K antagonist direct oral anticoagulant (NOAC) in 2009, the role of vitamin K antagonists has been replaced in most clinical settings except in a few conditions when NOACs are contraindicated. Data for the use of NOACs in different clinical scenarios have been accumulating in the recent decade, and a more sophisticated strategy for atrial fibrillation patients is now warranted. JACC: Asia recently appointed a working group to summarize the most updated information regarding stroke prevention in AF. This statement aimed to provide possible treatment option in daily practice. Local availability, cost, and patient comorbidities should also be considered. Final decisions may still need to be individualized and based on clinicians' discretion. This is the part 1 of the whole statement.

Keywords: ABC, atrial fibrillation better care; AF, atrial fibrillation; Asia; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant; PCI, percutaneous coronary intervention; TAVI, transcatheter aortic valve implantation; VKA, vitamin K antagonist; atrial fibrillation; non–vitamin K antagonist oral anticoagulant; stroke; vitamin K antagonist.

Publication types

  • Review