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Guidelines for the management of atrial fibrilation. European Heart Journal (2010) 31, 2369 - 2429
CHA2DS2 VASc Score
Guidelines for the management of atrial fibrilation. European Heart Journal (2010) 31, 2369 - 2429
Oral Anticoagulant :
1. Warfarin (INR 2.0 – 3.0)
2. New oral anticoagulant (Apixaban, rivoraxaban, dabigatran)
Guidelines for the management of atrial fibrilation. European Heart Journal (2010) 31, 2369 - 2429
HAS BLED SCORE
• To assess bleeding risk in AF patients
• Intracranial bleeding increases with INR values > 3.5 – 4.0, and there is no
increment in bleeding risk with INR values between 2.0 – 3.0 compared with
lower INR values
• The HAS BLED score good predictive value for intracranial bleeding
• The HAS BLED score makes clinicians think about the potentially
reversible risk factor for bleeding
HAS BLED SCORE
Guidelines for the management of atrial fibrilation. European Heart Journal (2010) 31, 2369 - 2429
• In patients with NSTEMI dual antiplatelet therapy is recommended
(aspirin + clopidogrel), but in AF patients at MODERATE to HIGH RISK
of STROKE OAC should be given
• In acute setting aspirin + clopidogrel + UFH or LMWH (enoxaparin) or
bivalirudin or GP IIb/IIIa inhibitor
• For medium to long term management, triple therapy (VKA,aspirin, and
clopidogrel) should be used in the initial periode (3-6 months) or for longer
in selected patients at low bleeding risk.
• In patients with high risk cardiovascular thrombotic complication ( GRACE
or TIMI Risk Score), long term therapy with VKA combined with
clopidogrel 75 mg daily (or aspirin 75-100 mg daily) + gastric protection for
12 months