Stroke Prevention in Atrial Fibrillation: Sharing Decision Making for Optimal Anticoagulation

Atrial fibrillation (AF) is associated with a 4- to 5-fold increase in the risk for ischemic stroke and systemic embolism, yet less than one-half of patients with AF undergo appropriate risk stratification and anticoagulant therapy. A challenge in the management of older patients with AF is balancing the need for anticoagulation to prevent stroke with the high risk of hemorrhage. This involves considering the limitations of traditional warfarin therapy and the complexities of newer anticoagulant treatments. This expert panel discussion features case examples highlighting effective clinician-patient communication about stroke prevention in AF.

Intended for primary care physicians, cardiologists, physician assistants, nurse practitioners, and hospitalists who treat patients with AF

After taking part in this educational activity, participants should be better able to:

• Recognize the large degree of underutilization of anticoagulation in patients with AF and the resultant morbidity, mortality, and health care costs
• Outline strategies recommended in clinical guidelines to assess risk for stroke and bleeding to optimize outcomes of anticoagulation therapy
• Evaluate the limitations, risks, challenges, and opportunities surrounding traditional and current anticoagulation therapies
• Implement strategies to improve communication and shared decision making between clinicians, patients/caregivers about the benefits and risks of anticoagulation therapy