AHA Updates Treatment Guidelines for Atrial Fibrillation

The American Heart Association (AHA; Dallas, TX, USA), American College of Cardiology (ACC; Washington, DC, USA), and the Heart Rhythm Society (HRS; Washington, DC, USA) now recommend the use of non-vitamin K oral anticoagulants (NOACs) over traditional warfarin to prevent stroke in people with atrial fibrillation (AF).

The recommendations are the result of a focused update to the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. The new guideline also suggests that NOACs could even be used in people at a lower risk of stroke than previously thought, with emerging research suggesting the benefit of NOACs in stroke reduction risk outweighs the risk of taking them. The recommendation was simultaneously published on January 29, 2019, in Circulation, the Journal of the American College of Cardiology (JACC), and HeartRhythm.

“Patients with atrial fibrillation are at increased risk of stroke, which can be devastating. A goal of treating AF patients is to make blood less likely to form clots, which reduces the risk of stroke,” said Craig T. January, MD, PhD, co-chair of the updated guideline committee. “NOACs may be safer for patients because there is less risk of bleeding, and they may also be more effective at preventing blood clots than warfarin. AF patients should talk to their healthcare provider about any concerns they have about their prescribed medications and whether or not losing weight would benefit their health.”

Until the introduction of NOACs, warfarin had been one of the only treatment options for long-term anticoagulation of patients with AF, venous thromboembolism (VTE), or other conditions that require chronic anticoagulation. The major benefit of the NOAC anticoagulants is that they do not require strict and frequent laboratory monitoring, dosing adjustments, or dietary restrictions, and incur fewer drug interactions than warfarin. NOACs include dabigatran, rivaroxaban, apixaban, and edoxaban.

Related Links:
American Heart Association
American College of Cardiology
Heart Rhythm Society