A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation

Atrial Fibrillation Saturday, July 21st, 2012

Eeurheartj.oxfordjournals.org: July 2, 2012.

Aims The availability of new antithrombotic agents, each with a unique efficacy and bleeding profile, has introduced a considerable amount of clinical uncertainty with physicians. We have developed a clinical decision aid in order to assist clinicians in determining an optimal antithrombotic regime for the prevention of stroke in patients who are newly diagnosed with non-valvular atrial fibrillation.

Methods and results The CHA2DS2-VASc and HAS-BLED scoring systems were used to assess patients’ baseline risks of stroke and major bleeding, respectively. The relative risks of stroke and major bleeding for each antithrombotic agent were then used to identify the agent associated with the lowest net risk. Individual patient factors such as the treatment threshold, bleeding ratio, and cost threshold modified the recommendations in order to generate a final recommendation. Read More

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