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Anticoagulation for atrial fibrillation in heart failure patients: balancing between Scylla and Charybdis

Grigorios Tsigkas1, Anastasiοs Apostolos1, Stefanos Despotopoulos1

  • 1Department of Cardiology, University Hospital of Patras, Patras, Greece.

Journal of Geriatric Cardiology : JGC
|June 21, 2021
PubMed

Insights

Managing heart failure (HF) and atrial fibrillation (AF) is complex. This review focuses on non-vitamin K oral anticoagulants (NOACs), the current standard for anticoagulation in HF patients with AF.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure (HF) and atrial fibrillation (AF) co-occur frequently and present management challenges.
  • Anticoagulation is crucial for AF patients with HF, with a shift from Vitamin-K antagonists to newer agents.

Purpose of the Study:

  • To review current literature on non-vitamin K oral anticoagulants (NOACs) in patients with both HF and AF.
  • To discuss indications, optimal choice, and usage of NOACs in this patient population.

Main Methods:

  • Literature review of current research on NOACs for AF in HF patients.
  • Analysis of guidelines and clinical trial data.

Main Results:

  • Non-vitamin K oral anticoagulants (NOACs) are increasingly the standard of care for anticoagulation in HF patients with AF.
  • Evidence supports NOACs across various HF phenotypes.

Conclusions:

  • NOACs represent a significant advancement in managing AF in HF patients.
  • Further research may refine optimal NOAC selection and use in specific HF scenarios.

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