Guideline summary · Cardiovascular · 7 min read

Atrial fibrillation: stroke prevention

CHA₂DS₂-VA, DOACs first, and the AF-CARE framework.

Key points

  1. The 2024 ESC guideline uses CHA₂DS₂-VA, which removes female sex as a risk factor.
  2. Oral anticoagulation is recommended with a score of 2 or more and should be considered with a score of 1.
  3. DOACs are preferred over warfarin except with mechanical heart valves or moderate-to-severe mitral stenosis.
  4. Bleeding risk scores should not be used to decide against anticoagulation; treat modifiable bleeding risks instead.
  5. Antiplatelet therapy alone is not an alternative to anticoagulation for stroke prevention.

Summary based on the ESC guidelines for the management of atrial fibrillation (2024). A study aid, not a substitute for the current guideline or local protocols.

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