The Living Guidelines: Preventing Thromboembolism Polling Results for CLASS IIa Guidelines
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Class IIa Guidelines
1. For primary prevention of thromboembolism in patients with non valvular AF who have just 1 of the following validated risk factors, antithrombotic therapy with either aspirin or a vitamin K antagonist is reasonable, based upon an assessment of the risk of bleeding complications, ability to safely sustain adjusted chronic anticoagulation, and patient preferences: age greater than or equal to 75 y (especially in female patients), hypertension, heart failure, impaired LV function, or diabetes mellitus. (Level of Evidence: A) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 1 for preventing thromboembolism should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
2. For patients with non valvular AF who have 1 or more of the following less well-validated risk factors, antithrombotic therapy with either aspirin or a vitamin K antagonist is reasonable for prevention of thromboembolism: age 65 to 74 y, female gender, or CAD. The choice of agent should be based upon the risk of bleeding complications, ability to safely sustain adjusted chronic anticoagulation, and patient preferences. (Level of Evidence: B) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 2 for preventing thromboembolism should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
3. It is reasonable to select antithrombotic therapy using the same criteria irrespective of the pattern (i.e., paroxysmal, persistent, or permanent) of AF. (Level of Evidence: B) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 3 for preventing thromboembolism should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
4. In patients with AF who do not have mechanical prosthetic heart valves, it is reasonable to interrupt anticoagulation for up to 1 week without substituting heparin for surgical or diagnostic procedures that carry a risk of bleeding. (Level of Evidence: C) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 4 for preventing thromboembolism should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
5. It is reasonable to reevaluate the need for anticoagulation at regular intervals. (Level of Evidence: C) [1]
<Poll>
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 5 for preventing thromboembolism should be:
CLASS I
CLASS IIa
CLASS IIb
CLASS III
</poll>
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation- Executive Summary: executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidlines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114: 700-752. PMID 16908781