Interdisziplinäre Aspekte der oralen Antikoagulation mit NOAKs bei Vorhofflimmern

 

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Zusammenfassung

Die Schlaganfallprophylaxe mit nicht von Vitamin K abhängigen oralen Antikoagulanzien (NOAKs) bei Patienten mit nichtvalvulärem Vorhofflimmern (nvVHF) hat heute einen festen Platz in der klinischen Routine. Die Definition des nvVHF umfasst die Abwesenheit einer mechanischen Herzklappe und ein nicht mit einer mittel- oder hochgradigen Mitralklappenstenose einhergehendes Vorhofflimmern. Das Management der oralen Antikoagulation (OAK) erfordert eine starke Interdisziplinarität. Nicht zuletzt aus diesem Grund sind in der Praxis immer wieder Unsicherheiten zu beobachten, die für den einzelnen Patienten weitreichende Folgen haben können. Deshalb hat sich ein Gremium aus Vertretern von Allgemeinmedizin, Geriatrie, Kardiologie, Nephrologie und Neurologie versammelt, um praxisrelevante Aspekte aus den verschiedenen Disziplinen zu identifizieren und gemeinsam praktische Handreichungen zu erarbeiten, die die Therapiesicherheit für die Patienten im Alltag verbessern sollen (Übersicht siehe [Abb. 1]).

Abstract

Stroke prophylaxis with non-vitamin K-dependent oral anticoagulants (NOAKs) in patients with non-valvular atrial fibrillation (nvVHF) is now firmly established in routine clinical practice. The definition of nvVHF includes the absence of a mechanical heart valve and AF not associated with moderate- or high-grade mitral valve stenosis. The management of oral anticoagulation (OAC) requires a high degree of interdisciplinarity. Not least for this reason, uncertainties are repeatedly observed in practice, which can have far-reaching consequences for the individual patient. For this reason, a committee consisting of representatives from general medicine, geriatrics, cardiology, nephrology and neurology has gathered to identify aspects of practical relevance from the various disciplines and to jointly develop practical guidelines to improve therapy safety for patients in everyday life.

Publication History

Article published online:
06 May 2021

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