This ACE Clinical Guidance (ACG) highlights the importance of anticoagulation for preventing stroke among patients with atrial fibrillation (AF). The ACG offers evidence-based recommendations and supporting guidance on initiation of anticoagulation, choice of oral anticoagulant (OAC) for different patient groups, and key monitoring parameters as part of regular follow-up of patients on direct oral anticoagulants (DOACs) or warfarin. A supplementary guide on how to switch between medications is included with the ACG.
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Registered doctors and pharmacists may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A for reading each ACG.
| ACG recommendations |
| 1. |
Estimate stroke risk for patients with AF and start OAC therapy for those with a modified CHA2DS2VASc score ≥ 2. |
| 2. |
Choose a DOAC as the preferred OAC therapy for patients with AF, except for patients with mechanical heart valves or moderate-to-severe mitral stenosis for whom warfarin is the treatment of choice. |
| 3. |
Conduct monitoring tests and relevant assessments to ensure the safe use of OAC therapy and to minimise bleeding risk. |
| 4. |
Reassess stroke risk and review the need for an OAC in patients who are not on OAC therapy at least annually, and when clinical circumstances change.
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Oral anticoagulation for atrial fibrillation (Nov 2023)
Oral anticoagulation for atrial fibrillation References (Nov 2023)
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