Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Atrial fibrillation

Anticoagulation for AF: can we GRASP-AF patients?

Nature Reviews Cardiology volume 10, pages 241–242 (2013)Cite this article

Subjects

Prevention of stroke in patients with atrial fibrillation (AF) requires oral anticoagulation therapy. We discuss the clinical utility of the GRASP-AF tool to identify patients with AF who are suitable for oral anticoagulation on the basis of their stroke risk profile, and propose assessment using the CHA2DS2–VASc score.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Hypothetical practice-level data summarizing AF prevalence, stroke risk factors (CHA2DS2–VASc score), and antithrombotic treatment using the GRASP-AF tool.

References

  1. Wilke, T. et al. Oral anticoagulation use by patients with atrial fibrillation in Germany. Adherence to guidelines, causes of anticoagulation under-use and its clinical outcomes, based on claims-data of 183,448 patients. Thromb. Haemost. 107, 1053–1065 (2012).

    Article  CAS  PubMed  Google Scholar 

  2. Camm, A. J. et al. 2012 focussed update of the ESC guidelines for the management of atrial fibrillation: an update of the 2010 ESC guidelines for the management of atrial fibrillation. Eur. Heart J. 33, 2719–2747 (2012).

    Article  Google Scholar 

  3. Cowan, C. et al. The use of anticoagulants in the management of atrial fibrillation among general practices in England. Heart http://dx.doi.org/10.1136/heartjnl-2012-303472.

  4. Lip, G. Y. et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest 137, 263–272 (2010).

    Article  Google Scholar 

  5. National Collaborating Centre for Chronic Conditions. Atrial Fibrillation: National Clinical Guideline for Management in Primary and Secondary Care (Royal College of Physicians, 2006).

  6. Mant, J. et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged study, BAFTA): a randomised controlled trial. Lancet 370, 493–503 (2007).

    Article  CAS  Google Scholar 

  7. Olesen, J. B., Torp-Pedersen, C., Hansen, M. L. & Lip, G. Y. The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0–1: a nationwide cohort study. Thromb. Haemost. 107, 1172–1179 (2012).

    Article  CAS  PubMed  Google Scholar 

  8. Banerjee, A., Lane, D. A., Torp-Pedersen, C. & Lip, G. Y. Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus no treatment in a 'real world' atrial fibrillation population: a modelling analysis based on a nationwide cohort study. Thromb. Haemost. 107, 584–589 (2012).

    Article  CAS  Google Scholar 

  9. Olesen, J. B. et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a 'real world' nationwide cohort study. Thromb. Haemost. 106, 739–749 (2011).

    Article  CAS  Google Scholar 

  10. Pisters, R., Nieuwlaat, R., Lane, D. A., Crijns, H. J. & Lip, G. Y. Potential net clinical benefit of population-wide implementation of apixaban and dabigatran among European patients with atrial fibrillation: a modelling analysis from the Euro Heart Survey. Thromb. Haemost. 109, 328–336 (2013).

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, B18 7QH, UK

    Deirdre A. Lane & Gregory Y. H. Lip

Authors
  1. Deirdre A. Lane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory Y. H. Lip
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory Y. H. Lip.

Ethics declarations

Competing interests

G. Y. H. Lip is or has been a consultant for and has received honoraria from Bayer, BMS/Pfizer, Boehringer Ingelheim, and Sanofi–Aventis; he has also received honoraria from Astellas/Daiichi–Sankyo and Merck/Astra–Zeneca. D. A. Lane has received honoraria and grant/research support from Bayer and Boehringer Ingelheim, and is or has been a consultant and has received honoraria from BMS/Pfizer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lane, D., Lip, G. Anticoagulation for AF: can we GRASP-AF patients?. Nat Rev Cardiol 10, 241–242 (2013). https://doi.org/10.1038/nrcardio.2013.47

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2013.47

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing