AF anticoagulation
June 12, 2014
NATIONAL Stroke Foundation
clinical council member Associate
Professor Timothy Kleinig said
the release of the UK’s National
Institute for Health and Care
Excellence (NICE) draft guidelines
on atrial fibrillation (PD 11 Jun)
would help focus people’s attention
on the fact that most patients
with AF should be anticoagulated
with warfarin or one of the
novel oral anticoagulants but
said NICE guidelines were not
necessarily accepted worldwide;
for the new oral anticoagulants,
the recommendation would not
affect Australia, as the country was
guided by Pharmaceutical Benefits
Scheme prescribing criteria, based
on the CHADS2 score.
“Regarding warfarin, most GPs
are now aware of the CHA2DS2VaSC
score and should use this to guide
decision making.
“NSF guidelines do not address
primary prevention of stroke – all
patients with AF who have had
an AF-related stroke should be
anticoagulated, unless there is a
clear contraindication, and this
guideline will not change.
“Whether or not use of the
NOACs should be used in patients
with CHA2DS2VaSC scores of 0 or
1 is uncertain, and would require
new trials.”
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