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Thrombosis Journal
Published in: Thrombosis Journal 1/2015

Open Access 01-12-2015 | Review

A case-based approach to implementing guidelines for stroke prevention in patients with atrial fibrillation: balancing the risks and benefits

Authors: Alpesh Amin, Steven Deitelzweig

Published in: Thrombosis Journal | Issue 1/2015

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Abstract

Atrial fibrillation (AF) puts patients at risk of complications, including stroke. Warfarin therapy has been the mainstay of antithrombotic treatment for reducing the risk of stroke in AF. However, warfarin has limitations that have motivated development of several novel oral anticoagulants (NOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban. Clinical trials demonstrate that the NOACs offer efficacy and safety that are equivalent to, or better than, those of warfarin for reducing the risk of stroke in patients with nonvalvular AF. This review examines stroke risk reduction in patients with AF from the perspective of the clinician balancing the risks and benefits of treatment options, evaluates the most recent guidelines, and discusses 2 hypothetical patient cases to better illustrate how clinicians may apply available data in the clinical setting. We reviewed guidelines for the reduction of stroke risk in AF and data from clinical trials on the NOACs. Choosing antithrombotic treatment involves assessing the benefits of therapy versus its risks. Risk indexes, including CHADS2, CHA2DS2-VASc, and HAS-BLED can help determine how to treat patients with AF. Current guidelines suggest using these risk indexes to customize treatment to individual patients. Many current treatment guidelines also incorporate recommendations for the use of NOACs as an alternative to warfarin. As additional data emerge and guidelines are updated, these recommendations will likely evolve. In the interim, clinicians may consider published guidelines and clinical trial results on NOACs. Real-world experience will provide clinicians with additional insight into their treatment decisions.
Literature
1.
Colilla S, Crow A, Simon T, Singer DE, Petkun W, Liu X. Projected estimates of prevalence and annual growth rate of atrial fibrillation in the United States from a dynamic age-period progression model. Circ Cardiovasc Qual Outcomes. 2012;5:A2056.
2.
Fuster V, Ryden LE, Cannom DS, Crijns H, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e257–354.PubMedCrossRef
3.
Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–8.PubMedCrossRef
4.
Dulli DA, Stanko H, Levine RL. Atrial fibrillation is associated with severe acute ischemic stroke. Neuroepidemiology. 2003;22:118–23.PubMedCrossRef
5.
Hannon N, Sheehan O, Kelly L, Marnane M, Merwick A, Moore A, et al. Stroke associated with atrial fibrillation–incidence and early outcomes in the north Dublin population stroke study. Cerebrovasc Dis. 2010;29:43–9.PubMedCrossRef
6.
Kim MH, Johnston SS, Chu BC, Dalal MR, Schulman KL. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313–20.PubMedCrossRef
7.
Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33:2719–47.PubMedCrossRef
8.
Furie KL, Goldstein LB, Albers GW, Khatri P, Neyens R, Mintu P, et al. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: a science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43:3442–53.PubMedCrossRef
9.
Culebras A, Messe SR, Chaturvedi S, Kase CS, Gronseth G. Summary of evidence-based guideline update: prevention of stroke in nonvalvular atrial fibrillation: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014;82:716–24.PubMedCentralPubMedCrossRef
10.
January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC Jr, Cigarroa JE, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;S0735-1097(14)01739-2. doi: 10.​1016/​j.​jacc.​2014.​03.​021.
11.
You JJ, Singer DE, Howard PA, Lane DA, Eckman MH, Fang MC, et al. Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e531S–75.PubMedCentralPubMed
12.
Anderson N, Fuller R, Dudley N. ‘Rules of thumb’ or reflective practice? Understanding senior physicians’ decision-making about anti-thrombotic usage in atrial fibrillation. QJM. 2007;100:263–9.PubMedCrossRef
13.
Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):160–198S.CrossRef
14.
Baker WL, Cios DA, Sander SD, Coleman CI. Meta-analysis to assess the quality of warfarin control in atrial fibrillation patients in the United States. J Manag Care Pharm. 2009;15:244–52.PubMed
15.
Hankey GJ, Eikelboom JW. Antithrombotic drugs for patients with ischaemic stroke and transient ischaemic attack to prevent recurrent major vascular events. Lancet Neurol. 2010;9:273–84.PubMedCrossRef
16.
Stroke Prevention in Atrial Fibrillation Investigators. Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation. 1991;84:527–39.CrossRef
17.
Suarez J, Piccini JP, Liang L, Atherton JJ, Hayward CS, Krum H, et al. International variation in use of oral anticoagulation among heart failure patients with atrial fibrillation. Am Heart J. 2012;163:804–11.PubMedCentralPubMedCrossRef
18.
Gattellari M, Worthington J, Zwar N, Middleton S. Barriers to the use of anticoagulation for nonvalvular atrial fibrillation: a representative survey of Australian family physicians. Stroke. 2008;39:227–30.PubMedCrossRef
19.
Hylek EM, D’Antonio J, Evans-Molina C, Shea C, Henault LE, Regan S. Translating the results of randomized trials into clinical practice: the challenge of warfarin candidacy among hospitalized elderly patients with atrial fibrillation. Stroke. 2006;37:1075–80.PubMedCrossRef
20.
Partington SL, Abid S, Teo K, Oczkowski W, O’Donnell MJ. Pre-admission warfarin use in patients with acute ischemic stroke and atrial fibrillation: the appropriate use and barriers to oral anticoagulant therapy. Thromb Res. 2007;120:663–9.PubMedCrossRef
21.
Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–67.PubMedCrossRef
22.
Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011;123:e269–367.PubMedCrossRef
23.
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.PubMedCrossRef
24.
Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.PubMedCrossRef
25.
Patel MR, Mahaffey KW, Garg J, Singer DE, Hacke W, Breithardt G, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.PubMedCrossRef
26.
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–104.PubMedCrossRef
27.
Daiichi Sankyo Co., ltd. Savaysa® (edoxaban tablets). Prescribing information. http://​dsi.​com/​prescribing-information-portlet/​getPIContent?​productName=​Savaysa&​inline=​true.​ 2015. Accessed 02 June 2015.
28.
29.
30.
31.
Connolly SJ, Ezekowitz MD, Yusuf S, Reilly PA, Wallentin L. Newly identified events in the RE-LY trial. N Engl J Med. 2010;363:1875–6.PubMedCrossRef
32.
Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S, et al. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364:806–17.PubMedCrossRef
33.
Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864–70.PubMedCrossRef
34.
Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation. Chest. 2010;137:263–72.PubMedCrossRef
35.
Baruch L, Gage BF, Horrow J, Juul-Möller S, Labovitz A, Persson M, et al. Can patients at elevated risk of stroke treated with anticoagulants be further risk stratified? Stroke. 2007;38:2459–63.PubMedCrossRef
36.
Go AS, Hylek EM, Chang Y, Phillips KA, Henault LE, Capra AM, et al. Anticoagulation therapy for stroke prevention in atrial fibrillation: how well do randomized trials translate into clinical practice? JAMA. 2003;290:2685–92.PubMedCrossRef
37.
Chen JY, Zhang AD, Lu HY, Guo J, Wang FF, Li ZC. CHADS2 versus CHA2DS2-VASc score in assessing the stroke and thromboembolism risk stratification in patients with atrial fibrillation: a systematic review and meta-analysis. J Geriatr Cardiol. 2013;10:258–66.PubMedCentralPubMed
38.
Coppens M, Eikelboom JW, Hart RG, Yusuf S, Lip GY, Dorian P, et al. The CHA2DS2-VASc score identifies those patients with atrial fibrillation and a CHADS2 score of 1 who are unlikely to benefit from oral anticoagulant therapy. Eur Heart J. 2013;34:170–6.PubMedCrossRef
39.
Olesen JB, Torp-Pedersen C, Hansen ML, Lip GY. The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0–1: a nationwide cohort study. Thromb Haemost. 2012;107:1172–9.PubMedCrossRef
40.
Lip GY, Frison L, Halperin JL, Lane DA. Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke. 2010;41:2731–8.PubMedCrossRef
41.
Oldgren J, Alings M, Darius H, Eikelboom J, Ezekowitz MD, Kamensky G, et al. RE-LY Investigators. Risks for stroke, bleeding, and death in patients with atrial fibrillation receiving dabigatran or warfarin in relation to the CHADS2 score: a subgroup analysis of the RE-LY trial. Ann Intern Med. 2011;155:660–7. doi:10.​7326/​0003-4819-155-10-201111150-00004.PubMedCrossRef
42.
Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138:1093–100.PubMedCrossRef
43.
Stroke Prevention in Atrial Fibrillation Investigators. Predictors of thromboembolism in atrial fibrillation: I. Clinical features of patients at risk. Ann Intern Med. 1992;116:1–5.CrossRef
44.
SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study. JAMA. 1998;279:1273–7.CrossRef
45.
Atrial Fibrillation Investigators. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med. 1994;154:1449–57.CrossRef
46.
Estes III NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS, et al. ACC/AHA/Physician Consortium 2008 Clinical Performance Measures for Adults with Nonvalvular Atrial Fibrillation or Atrial Flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation) Developed in Collaboration with the Heart Rhythm Society. J Am Coll Cardiol. 2008;51:865–84.PubMedCrossRef
47.
48.
49.
Crowther M, Kitt M, Lorenz T, Mathur V, Lu G, Hutchaleelaha A, et al. A phase 2 randomized, double-blind, placebo-controlled trial of PRT064445, a novel, universal antidote for direct and indirect factor Xa inhibitors [abstract]. J Thromb Haemost. 2013;11(s2):30.
50.
Eerenberg ES, Kamphuisen PW, Sijpkens MK, Meijers JC, Buller HR, Levi M. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011;124:1573–9.PubMedCrossRef
51.
Escolar G, Arellano-Rodrigo E, Reverter JC, Villalta J, Sanz V, Molina P, et al. Reversal of apixaban induced alterations of hemostasis by different coagulation factor concentrates: studies in vitro with circulating human blood [Abstract]. Circulation. 2012;126:520–1.CrossRef
52.
Lu G, Deguzman FR, Karbarz MJ, Hollenbach SJ, Conley PB, Hutchaleelaha A, et al. Reversal of rivaroxaban mediated anticoagulation in animal models by a recombinant antidote protein (r-Antidote, PRT064445) [abstract]. Eur Heart J. 2011;32:640–1.
53.
Perzborn E, Tinel H. FEIBA reverses the effects of a high dose of rivaroxaban in rats [abstract P061]. Pathophysiol Haemost Thromb. 2008;36:A40.
54.
Stangier J, Rathgen K, Stahle H, Mazur D. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet. 2010;49:259–68.PubMedCrossRef
55.
van Ryn J, Ruehl D, Priepke H, Hauel NH, Wienen W. Reversibility of the anticoagulant effect of high doses of the direct thrombin inhibitor dabigatran, by recombinant factor VIIa or activated prothrombin complex concentrate. Haematologica. 2008;93 Suppl 1:48.
56.
Fukuda T, Honda Y, Kamisato C, Morishima Y, Shibano T. Reversal of anticoagulant effects of edoxaban, an oral, direct factor Xa inhibitor, with haemostatic agents. Thromb Haemost. 2012;107:253–9.PubMedCrossRef
57.
Ogata K, Mendell-Harary J, Tachibana M, Masumoto H, Oguma T, Kojima M, et al. Clinical safety, tolerability, pharmacokinetics, and pharmacodynamics of the novel factor Xa inhibitor edoxaban in healthy volunteers. J Clin Pharmacol. 2010;50:743–53.PubMedCrossRef
58.
Mendell J, Zahir H, Matsushima N, Noveck R, Lee F, Chen S, et al. Drug-drug interaction studies of cardiovascular drugs involving P-glycoprotein, an efflux transporter, on the pharmacokinetics of edoxaban, an oral factor Xa inhibitor. Am J Cardiovasc Drugs. 2013;13:331–42.PubMedCentralPubMedCrossRef
59.
60.
Rose AJ, Hylek EM, Ozonoff A, Ash AS, Reisman JI, Berlowitz DR. Patient characteristics associated with oral anticoagulation control: results of the Veterans AffaiRs Study to Improve Anticoagulation (VARIA). J Thromb Haemost. 2010;8:2182–91.PubMedCrossRef
61.
Van Spall HG, Wallentin L, Yusuf S, Eikelboom JW, Nieuwlaat R, Yang S, et al. Variation in warfarin dose adjustment practice is responsible for differences in the quality of anticoagulation control between centers and countries: an analysis of patients receiving warfarin in the randomized evaluation of long-term anticoagulation therapy (RE-LY) trial. Circulation. 2012;126:2309–16.PubMedCrossRef
62.
63.
Bytzer P, Connolly SJ, Yang S, Ezekowitz M, Formella S, Reilly PA, et al. Analysis of upper gastrointestinal adverse events among patients given dabigatran in the RE-LY trial. Clin Gastroenterol Hepatol. 2013;11:246–52.PubMedCrossRef
64.
Darius H, Clemens A, Healey JS, Avezum A, Nagarakanti R, Chin A, et al. Comparison of dabigatran versus warfarin in diabetic patients with atrial fibrillation: results from the RE-LY trial [abstract]. Circulation. 2012;126:A15937.
65.
Goodman SG, Wojdyla DM, White HD, Piccini JP, Paolini JF, Nessel CC, et al. Predictors of major bleeding risk: insights from the rivaroxaban once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF) [abstract]. Circulation. 2011;124:A16903.
66.
Frost C, Yu Z, Nepal S, Bragat A, Moore K, Shenker A, et al. Apixaban, a direct factor Xa inhibitor: single-dose pharmacokinetics and pharmacodynamics of an intravenous formulation [abstract 148]. J Clin Pharmacol. 2008;48:1132.
67.
Vakkalagadda B, Frost C, Wang J, Nepal S, Schuster A, Zhang D, et al. Effect of rifampin on the pharmacokinetics of apixaban, an oral direct inhibitor of factor Xa [abstract]. J Clin Pharmacol. 2009;49:1091–130.
68.
Weinz C, Schwarz T, Kubitza D, Mueck W, Lang D. Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans. Drug Metab Dispos. 2009;37:1056–64.PubMedCrossRef
69.
Blech S, Ebner T, Ludwig-Schwellinger E, Stangier J, Roth W. The metabolism and disposition of the oral direct thrombin inhibitor, dabigatran, in humans. Drug Metab Dispos. 2008;36:386–99.PubMedCrossRef
70.
Wang L, He K, Maxwell B, Grossman SJ, Tremaine LM, Humphreys WG, et al. Tissue distribution and elimination of [14C] apixaban in rats. Drug Metab Dispos. 2011;39:256–64.PubMedCrossRef
71.
Wang X, Mondal S, Wang J, Tirucherai G, Zhang D, Boyd RA, et al. Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. Am J Cardiovasc Drugs. 2014;14:147–54.PubMedCentralPubMedCrossRef
72.
Hohnloser SH, Hijazi Z, Thomas L, Alexander JH, Amerena J, Hanna M, et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J. 2012;33:2821–30.PubMedCrossRef
73.
Lip GY, Larsen TB, Skjoth F, Rasmussen LH. Indirect comparisons of new oral anticoagulant drugs for efficacy and safety when used for stroke prevention in atrial fibrillation. J Am Coll Cardiol. 2012;60:738–46.PubMedCrossRef
74.
Mantha S, Ansell J. An indirect comparison of dabigatran, rivaroxaban and apixaban for atrial fibrillation. Thromb Haemost. 2012;108:476–84.PubMedCrossRef
75.
Testa L, Agnifili M, Latini RA, Mattioli R, Lanotte S, De Marco F, et al. Adjusted indirect comparison of new oral anticoagulants for stroke prevention in atrial fibrillation. QJM. 2012;105:949–57.PubMedCrossRef
76.
Laulicht B, Bakhru S, Lee C, Baker C, Jiang X, Mathiowitz E, et al. Small molecule antidote for anticoagulants [abstract]. Circulation. 2012;126:A11395.
Metadata
Title
A case-based approach to implementing guidelines for stroke prevention in patients with atrial fibrillation: balancing the risks and benefits
Authors
Alpesh Amin
Steven Deitelzweig
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Thrombosis Journal / Issue 1/2015
Electronic ISSN: 1477-9560
DOI
https://doi.org/10.1186/s12959-015-0056-y

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