Physician's Fear of Anticoagulant Therapy in Nonvalvular Atrial Fibrillation

Overview

Journal Am J Med Sci

Publisher Elsevier

Specialty General Medicine

Date 2014 Oct 7

PMID 25285512

Citations 26

Authors

Souvik Sen

Katherine Willett Dahlberg

Affiliations

Soon will be listed here.

Abstract

Despite the availability of predictive tools and treatment guidelines, anticoagulant therapies are underprescribed and many patients are undertreated for conditions that predispose to thromboembolic complications, including stroke. This review explores reasons for which physicians fear that the risks of anticoagulation may be greater than the potential benefit. The results of numerous clinical trials confirm that patients benefit from judiciously managed anticoagulation and that physicians can take various approaches to minimize risk. Use of stratification scores for patient selection and accurate estimation of stroke risk may improve outcomes; bleeding risk is less important than stroke risk. Adoption of newer anticoagulants with simpler regimens may help physicians allay their fears of anticoagulant use in patients with atrial fibrillation. These fears, although not groundless, should not overtake caution and hinder the delivery of appropriate evidence-based care.

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