Focused update of the ACC/AHA/HRS atrial fibrillation guideline (March 2019)

Focused update of the ACC/AHA/HRS atrial fibrillation guideline (March 2019)

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2019년 ACC/AHA/HRS는 atrial fibrillation management 가이드라인을 update하였습니다. 의미 있는 변화는 기계 판막이나 moderate - severe mitral stenosis 환자만 제외하는 direct acting anticoagulants 사용 적응증의 확장과 AF 환자에서 대체 항혈전제로서 아스피린을 뺀 것입니다.

The American College of Cardiology, American Heart Association and the Heart Rhythm Society (ACC/AHA/HRS) have updated their guideline for the management of patients with atrial fibrillation. Significant changes addressed in the focused update include extending indications for the use of direct acting anticoagulants, with exclusion only for patients with mechanical valves or with moderate to severe mitral stenosis, and eliminating aspirin as an alternative antithrombotic strategy for patients with atrial fibrillation.

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1) Mechanical heart valves, 2) moderate or severe mitral stenosis, 3) valvular lesions associated with moderate to severe heart failure that might lead to valve replacement in the near future 환자들에서 NOAC을 사용해서는 안됩니다.

Patients with mechanical heart valves, those with moderate or severe mitral stenosis of any origin, or those with other valvular lesions associated with moderate to severe heart failure that might lead to valve replacement in the near future. These patients should not receive NOAC agents.

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AF 환자에서 혈전색전증을 예방을 위한 단독 치료로서 아스피린 사용을 지지한 증거는 없습니다.

The evidence does not support the use of aspirin as monotherapy for the prevention of thromboembolic events in patients with AF.

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REF. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society