Antikoagulace, antiagregace nebo obojí u pa cientů s ischemickou chorobou srdeční a fi brilací síní
| Title in English | What to use in patients with ischaemic heart disease and atrial brillation – anticoagulation, antiaggregation or both? |
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| Authors | |
| Year of publication | 2016 |
| Type | Article in Periodical |
| Magazine / Source | Kardiologická revue - Interní medicína |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | atrial fibrillation; ischaemic heart disease; anticoagulation; antiagregation |
| Description | A combination of atrial fi brillation and ischaemic heart disease is quite common and antiaggregation or anticoagulation treatment should improve the prognosis of the patients. However, clear evidence is missing and recommendations contained in offi cial guidelines sometimes diff er. There are no clinical trials comparing warfarin and new anticoagulants (NOAC) in patients after coronary intervention, and there are also no data about the combination of NOAC with new antiaggregation drugs such as ticagrelor or prasugrel. The combination of antiaggregation (mono or dual) with NOAC or warfarin signifi cantly increases the risk of bleeding, and therefore the intensity and the duration of treatment should be individualised and scoring systems such as CHA2DS2-VASc or HAS- -BLED should be used. Anticoagulation alone (preferably NOAC) should be given to patients with chronic ischaemic heart disease (> 1 year) and atrial fi brillation. |