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When to withhold oral anticoagulation in atrial fibrillation – an overview of frequent clinical discussion topics

Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicia...

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Detalles Bibliográficos
Autores principales: Seelig, Jaap, Pisters, Ron, Hemels, Martin E, Huisman, Menno V, ten Cate, Hugo, Alings, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755244/
https://www.ncbi.nlm.nih.gov/pubmed/31571891
http://dx.doi.org/10.2147/VHRM.S187656
Descripción
Sumario:Stroke prevention with oral anticoagulants in patients with atrial fibrillation predisposes for bleeding. As a result, in select patient groups anticoagulation is withheld because of a perceived unfavorable risk-benefit ratio. Reasons for withholding anticoagulation can vary greatly between clinicians, often leading to discussion in daily clinical practice on the best approach. To guide clinical decision-making, we have reviewed available evidence on the most frequently reported reasons for withholding anticoagulation: previous bleeding, frailty and age, and an overall high bleeding risk.