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Title: Stroke prevention in atrial fibrillation - An Asian stroke perspective
Authors: Hung Fat Tse
Yong Jun Wang
Moheeb Ahmed Ai-Abdullah
Annette B. Pizarro-Borromeo
Chern En Chiang
Rungroj Krittayaphong
Balbir Singh
Amit Vora
Chun Xue Wang
Mohammad Zubaid
Andreas Clemens
Paul Lim
Dayi Hu
The University of Hong Kong
Beijing Tiantan Hospital
Prince Sultan Cardiac Centre
Philippine Heart Centre
National Yang-Ming University Taiwan
Mahidol University
Medanta Heart Institute
Arrhythmia Associates
Health Sciences Center Kuwait Faculty of Medicine
Boehringer Ingelheim Pharma GmbH & Co. KG
Bruker Singapore Pte. Ltd.
Peking University
Keywords: Medicine
Issue Date: 1-Jul-2013
Citation: Heart Rhythm. Vol.10, No.7 (2013), 1082-1088
Abstract: Despite relatively lower prevalence of atrial fibrillation (AF) in Asians (~1%) than in Caucasians (~2%), Asia has a much higher overall disease burden because of its proportionally larger aged population. For example, on the basis of reported age-adjusted prevalence rates and projected population figures in China, there will be an estimated 5.2 million men and 3.1 million women with AF older than 60 years by year 2050. Stroke is a disabling complication of AF that is of increasing cause for concern in Asians patients. Implementing consensus expert recommendations for managing stroke risk in patients with AF can considerably reduce stroke rates. However, caution is necessary when aligning management of Asian patients with AF to that of their Caucasian counterparts. Current international guidelines and risk stratification tools for AF management are based on findings in predominantly Caucasian populations and may therefore have limited relevance, in certain respects, to Asian patients. Oral anticoagulants play an important role in preventing AF-related stroke. The vitamin K antagonist warfarin is recommended for reducing the risk of stroke and thromboembolism in high-risk patients with nonvalvular AF; however, warfarin interacts with many drugs and food ingredients, which may pose significant challenges in administration and monitoring among Asian patients. Further research is needed to inform specific guidance on the implications of different stroke and bleeding profiles in Asians vs Caucasians. Moreover, there is scope to improve physician perceptions and patient knowledge, as well as considering alternative new oral anticoagulants, for example, direct thrombin inhibitors or factor Xa inhibitors. © 2013 Heart Rhythm Society.
ISSN: 15563871
Appears in Collections:Scopus 2011-2015

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