Atrial Fibrillation Management
Patient Selection for Aspirin Therapy
- The American College of Cardiology recommends aspirin 325 mg daily for patients with atrial fibrillation and no other risk factors, as the appropriate antithrombotic therapy 1, 2, 3, 4
- For patients aged <60 years with no heart disease (lone AF), the American College of Cardiology recommends aspirin 325 mg daily or no therapy (Class I recommendation) 1, 2, 3, 4
- The American College of Cardiology recommends aspirin 325 mg daily for patients aged <60 years with heart disease but no risk factors (Class I recommendation) 1, 2
- For patients aged ≥60 years with no risk factors, the American College of Cardiology recommends aspirin 325 mg daily (Class I recommendation) 1, 2, 3, 4
Risk Factors for Stroke
- Prior stroke, TIA, or systemic embolism is considered a high-risk factor for stroke in patients with atrial fibrillation 5
- Age ≥75 years is considered a moderate-risk factor for stroke in patients with atrial fibrillation 5, 6, 7
- Heart failure or LV ejection fraction ≤35% is considered a moderate-risk factor for stroke in patients with atrial fibrillation 1, 5, 6, 7
- Hypertension is considered a moderate-risk factor for stroke in patients with atrial fibrillation 5, 6, 7
- Diabetes mellitus is considered a moderate-risk factor for stroke in patients with atrial fibrillation 5, 6, 7
Anticoagulation Therapy
- Warfarin is reserved for patients with ≥1 high-risk factor or >1 moderate-risk factor for stroke 5, 6, 7
- The American College of Cardiology recommends against the use of clopidogrel alone or the aspirin/clopidogrel combination for stroke prevention in patients with atrial fibrillation 1, 5, 6, 7, 9