‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF

Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below are 10 important take-aways from the 2018 EHRA NOAC Practical Guide:NOACs can generally be used in patients withvalvular heart disease except patients with mechanical heart valves or rheumatic mitral stenosis.TheEHRA NOAC card is recommended to be distributed to patients on NOACs at initiation and during follow-up.Proper education and patient-tailored approaches (e.g. pill-box; calendar; electronic reminders) should be used toensure optimal adherence to the prescribed NOAC regimen.Whenever possible, the tested standard dose of NOACs should be used to provide optimal benefit for the patient.Dose reduction of NOACs is primarily guided by the dose reduction criteria used in the large phase III trials.Check for possibledrug –drug interactions in every patient (started) on a NOAC. Explore alternative drugs (NOACs and others) in case of relevant interactions.Ass...
Source: European Heart Journal - Category: Cardiology Source Type: research