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[Challenges of long-term anticoagulation in women: is heart failure relevant?]

Anetta Undas

    Przeglad Lekarski
    |April 20, 2018
    PubMed

    Insights

    Women with atrial fibrillation (AF) and heart failure (HF) face higher stroke risks. Newer anticoagulants (NOAC) show promise in improving outcomes by managing anticoagulation more effectively than older drugs (VKA).

    Area of Science:

    • Cardiology
    • Pharmacology
    • Internal Medicine

    Background:

    • Women with atrial fibrillation (AF) have elevated risks of stroke and peripheral embolization, often linked to comorbidities like heart failure (HF).
    • Traditional anticoagulant therapy with vitamin K antagonists (VKA) yields suboptimal clinical outcomes in women due to a higher incidence of unstable anticoagulation compared to men.

    Purpose of the Study:

    • To review the challenges associated with anticoagulation in women diagnosed with atrial fibrillation (AF) and heart failure (HF).
    • To highlight the potential benefits of non-vitamin K oral anticoagulants (NOAC) in this patient population.

    Main Methods:

    • Literature review focusing on studies comparing anticoagulation therapies in women with AF and HF.
    • Analysis of clinical outcomes, focusing on stroke prevention and bleeding events.
    • Examination of the role of NOACs versus VKAs in managing anticoagulation stability.

    Main Results:

    • Non-vitamin K oral anticoagulants (NOAC) are increasingly utilized for stroke prevention in nonvalvular AF.
    • NOACs appear particularly advantageous for women, potentially mitigating adverse events linked to anticoagulation instability.
    • This review underscores the improved efficacy and safety profile of NOACs in women with AF and HF.

    Conclusions:

    • Women with AF and HF present unique challenges in anticoagulation management.
    • NOACs offer a significant therapeutic advancement, providing more stable anticoagulation and improved outcomes compared to VKAs.
    • Further research and clinical practice should prioritize NOACs for anticoagulation in women with AF and HF.

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