Atrial fibrillation in patients with liver disease: Recent advances
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| Název: | Atrial fibrillation in patients with liver disease: Recent advances |
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| Autoři: | Godtfredsen, Sissel J, Kragholm, Kristian H, Pareek, Manan |
| Zdroj: | Godtfredsen, S J, Kragholm, K H & Pareek, M 2023, 'Atrial fibrillation in patients with liver disease : Recent advances', Kardiologia Polska, vol. 81, no. 10, pp. 950-959. https://doi.org/10.33963/v.kp.97812 |
| Informace o vydavateli: | Polskie Towarzystwo Kardiologiczne, 2023. |
| Rok vydání: | 2023 |
| Témata: | anticoagulants, liver diseases, Liver Diseases, Liver Diseases/complications, liver failure, Anticoagulants, Administration, Oral, Hemorrhage, 3. Good health, Ischemic Stroke/chemically induced, Stroke, Anticoagulants/therapeutic use, Risk Factors, Hemorrhage/chemically induced, Atrial Fibrillation, Humans, atrial fibrillation, Atrial Fibrillation/complications, Stroke/drug therapy, Ischemic Stroke |
| Popis: | Atrial fibrillation is associated with significant morbidity and mortality, and its incidence is increasing globally. The primary complication of atrial fibrillation is ischemic stroke, whose risk may be reduced with oral anticoagulant agents, i.e., either vitamin K antagonists or direct oral anticoagulants. Patients with atrial fibrillation often have concomitant hepatic impairment, particularly because of increasing rates of non-alcoholic liver disease. However, anticoagulation in patients with liver disease is challenging due to the pathophysiological changes of the coagulation cascade and, as a result, an increased risk of major bleeding in such individuals. Furthermore, monitoring of the degree of anticoagulation is complicated in patients with liver disease due to issues such as spontaneous international normalized ratio (INR) elevation, changes in hepatic drug elimination, and thrombocytopenia. We review the current evidence on atrial fibrillation and anticoagulation in patients with liver disease. We suggest having a strong focus on risk factor management and argue that the risk of ischemic stroke often outweighs the risk of hemorrhagic events in this setting. |
| Druh dokumentu: | Article |
| Popis souboru: | application/pdf |
| ISSN: | 1897-4279 0022-9032 |
| DOI: | 10.33963/v.kp.97812 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/37823759 https://vbn.aau.dk/ws/files/579844388/97812-402878-3-PB.pdf https://doi.org/10.33963/v.kp.97812 http://www.scopus.com/inward/record.url?scp=85176508170&partnerID=8YFLogxK https://vbn.aau.dk/da/publications/be683ee3-1d86-447a-96e4-8bf38f6b17a2 |
| Přístupové číslo: | edsair.doi.dedup.....5994bad09ca213df33e24925560fef0f |
| Databáze: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstrakt: | Atrial fibrillation is associated with significant morbidity and mortality, and its incidence is increasing globally. The primary complication of atrial fibrillation is ischemic stroke, whose risk may be reduced with oral anticoagulant agents, i.e., either vitamin K antagonists or direct oral anticoagulants. Patients with atrial fibrillation often have concomitant hepatic impairment, particularly because of increasing rates of non-alcoholic liver disease. However, anticoagulation in patients with liver disease is challenging due to the pathophysiological changes of the coagulation cascade and, as a result, an increased risk of major bleeding in such individuals. Furthermore, monitoring of the degree of anticoagulation is complicated in patients with liver disease due to issues such as spontaneous international normalized ratio (INR) elevation, changes in hepatic drug elimination, and thrombocytopenia. We review the current evidence on atrial fibrillation and anticoagulation in patients with liver disease. We suggest having a strong focus on risk factor management and argue that the risk of ischemic stroke often outweighs the risk of hemorrhagic events in this setting. |
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| ISSN: | 18974279 00229032 |
| DOI: | 10.33963/v.kp.97812 |