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2021 대한부정맥학회 심방세동 환자의 뇌졸중 예방 관리 지침

2021 Korean Heart Rhythm Society Guidelines for Stroke Prevention in Atrial Fibrillation

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초록

Atrial fibrillation (AF) is a strong risk factor for ischemic stroke and systemic embolism. To prevent thromboembolic events in patients with AF, anticoagulation therapy is essential. The anticoagulant strategy is determined after stroke and bleeding risk assessments using the CHA2DS2-VASc and HAS-BLED scores, respectively; both consider clinical risk factors. Vitamin K antagonists (VKAs) are the sole anticoagulant option in AF patients with a prosthetic mechanical valve or moderate-severe mitral stenosis; in all other AF patients VKA or non-vitamin K antagonist oral anticoagulants are therapeutic options. However, antiplatelet therapy should not be used for stroke prevention in AF patients. Anticoagulation is not needed in AF patients with low stroke risk but strongly recommended in those with a with low bleeding risk. Left atrial appendage (LAA) occlusion offers an alternative in AF patients in whom long-term anticoagulation is contraindicated. Surgical occlusion or the exclusion of LAA can be considered for stroke prevention in AF patients undergoing cardiac surgery. In this article, we review existing data for stroke prevention and suggest optimal strategies to prevent stroke in AF patients.

Abstract

Atrial fibrillation (AF) is a strong risk factor for ischemic stroke and systemic embolism. To prevent thromboembolic events in patients with AF, anticoagulation therapy is essential. The anticoagulant strategy is determined after stroke and bleeding risk assessments using the CHA2DS2-VASc and HAS-BLED scores, respectively; both consider clinical risk factors. Vitamin K antagonists (VKAs) are the sole anticoagulant option in AF patients with a prosthetic mechanical valve or moderate-severe mitral stenosis; in all other AF patients VKA or non-vitamin K antagonist oral anticoagulants are therapeutic options. However, antiplatelet therapy should not be used for stroke prevention in AF patients. Anticoagulation is not needed in AF patients with low stroke risk but strongly recommended in those with a with low bleeding risk. Left atrial appendage (LAA) occlusion offers an alternative in AF patients in whom long-term anticoagulation is contraindicated. Surgical occlusion or the exclusion of LAA can be considered for stroke prevention in AF patients undergoing cardiac surgery. In this article, we review existing data for stroke prevention and suggest optimal strategies to prevent stroke in AF patients.

참고문헌 (133)

  1. Pisters R, "Stroke and thromboembolism in atrial fibrillation", Circ J, 76, pp.2289~2304 (2012)
  2. Szymanski FM, "Stroke risk factors beyond the CHA₂DS₂-VASc score : can we improve our identification of"high stroke risk"patients with atrial fibrillation?", Am J Cardiol, 116, pp.1781~1788 (2015)
  3. Ganesan AN, "The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding : a systematic review and meta-analysis", Eur Heart J, 37, pp.1591~1602 (2016)
  4. Allan V, "Are cardiovascular risk factors also associated with the incidence of atrial fibrillation? A systematic review and field synopsis of 23 factors in 32 population-based cohorts of 20 million participants", Thromb Haemost, 117, pp.837~850 (2017)
  5. Banerjee A, "Ejection fraction and outcomes in patients with atrial fibrillation and heart failure : the Loire Valley Atrial Fibrillation Project", Eur J Heart Fail, 14, pp.295~301 (2012)
  6. Lee SE, "Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy", Heart, 10, pp.1496~1501 (2017)
  7. Shin SY, "Identification of markers associated with development of stroke in "clinically low-risk" atrial fibrillation patients", J Am Heart Assoc., 8, pp.e012697~ (2019)
  8. Kang SH, "Risk of ischemic stroke in patients with non-valvular atrial fibrillation not receiving oral anticoagulants-Korean nationwide population-based study", Circ J, 81, pp.1158~1164 (2017)
  9. Jung H, "Stroke risk stratification for atrial fibrillation patients with hypertrophic cardiomyopathy", J Am Coll Cardiol, 72, pp.2409~2411 (2018)
  10. Wu VC, "Female sex as a risk factor for ischaemic stroke varies with age in patients with atrial fibrillation", Heart, 106, pp.534~540 (2020)
  11. Tomasdottir M, "Risk of ischemic stroke and utility of CHA2 DS2-VASc score in women and men with atrial fibrillation", Clin Cardiol, 42, pp.1003~1009 (2019)
  12. Friberg L, "Assessment of female sex as a risk factor in atrial fibrillation in Sweden: nationwide retrospective cohort study", BMJ, 344, pp.e3522~ (2012)
  13. Overvad TF, "Stroke risk stratification:CHA2DS2-VA or CHA2DS2-VASc?", Heart Lung Circ, 28, pp.e14~e15 (2019)
  14. Nielsen PB, "Female sex as a risk modifier for stroke risk in atrial fibrillation : using CHA2DS2-VASc versus CHA2DS2-VA for stroke risk stratification in atrial fibrillation : a note of caution", Thromb Haemost, 120, pp.894~898 (2020)
  15. Nielsen PB, "Female sex is a risk modifier rather than a risk factor for stroke in atrial fibrillation : should we use a CHA2DS2-VA score rather than CHA2DS2-VASc?", Circulation, 137, pp.832~840 (2018)
  16. Marzona I, "Sex differences in stroke and major adverse clinical events in patients with atrial fibrillation : a systematic review and meta-analysis of 993, 600 patients", Int J Cardiol, 269, pp.182~191 (2018)
  17. , vascular disease, age 65-74, female)for stroke in Asian patients with atrial fibrillation : a Korean nationwide sample cohort study, "Stroke", 2017, 1524~1530
  18. Kim TH, "CHA2DS2-VASc score for identifying truly low-risk atrial fibrillation for stroke : a Korean nationwide cohort study", Stroke, 48, pp.2984~2990 (2017)
  19. Vinereanu D, "Echocardiographic risk factors for stroke and outcomes in patients with atrial fibrillation anticoagulated with apixaban or warfarin", Stroke, 48, pp.3266~3273 (2017)
  20. "Echocardiographic predictors of stroke in patients with atrial fibrillation: a prospective study of 1066 patients from 3clinical trials", Arch Intern Med., 158, pp.1316~1320 (1998)
  21. Friberg L, "Balancing stroke and bleeding risks in patients with atrial fibrillation and renal failure : the Swedish atrial fibrillation cohort study", Eur Heart J, 36, pp.297~306 (2015)
  22. Poli M, "Atrial fibrillation is a major cause of stroke in apneic patients : a prospective study", Sleep Med, 30, pp.251~254 (2017)
  23. Bassand JP, "Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: rationale for comprehensive management of atrial fibrillation", PLoS One, 13, pp.e0191592~ (2018)
  24. Overvad TF, "Body mass index and adverse events in patients with incident atrial fibrillation", Am J Med, 126, pp.640~ (2013)
  25. Lee JM, "Additional value of left atrial appendage geometry and hemodynamics when considering anticoagulation strategy in patients with atrial fibrillation with low CHA2DS2-VASc scores", Heart Rhythm, 14, pp.1297~1301 (2017)
  26. Baek YS, "Associations of abdominal obesity and new-onset atrial fibrillation in the general population", J Am Heart Assoc., 6, pp.e004705~ (2017)
  27. Kim TH, "Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation", J Cardiol, 68, pp.104~109 (2016)
  28. Hijazi Z, "Application of biomarkers for risk stratification in patients with atrial fibrillation", Clin Chem, 63, pp.152~164 (2017)
  29. 이기홍, "Association between Serum Parathyroid Hormone Levels and the Prevalence of Atrial Fibrillation: the Dong-gu Study", Korean Circulation Journal, 48(2), pp.159~167 (2018), 대한심장학회[DOI]
  30. Lip GY, "Additive role of plasma von Willebrand factor levels to clinical factors for risk stratification of patients with atrial fibrillation", Stroke, 37, pp.2294~2300 (2006)
  31. Chao TF, "Incident risk factors and major bleeding in patients with atrial fibrillation treated with oral anticoagulants : a comparison of baseline, follow-up and delta HAS-BLED scores with an approach focused on modifiable bleeding risk factors", Thromb Haemost, 118, pp.768~777 (2018)
  32. Man-Son-Hing M, "Choosing antithrombotic therapy for elderly patients with atrial fibrillation who are at risk for falls", Arch Intern Med, 159, pp.677~685 (1999)
  33. Esteve-Pastor MA, "Long-term bleeding risk prediction in 'real world' patients with atrial fibrillation: comparison of the HAS-BLED and ABC-bleeding risk scores. The murcia atrial fibrillation project", Thromb Haemost, 117, pp.1848~1858 (2017)
  34. Borre ED, "Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation : a systematic review", Thromb Haemost, 118, pp.2171~2187 (2018)
  35. Caldeira D, "Performance of the HAS-BLED high bleeding-risk category, compared to ATRIA and HEMORR2HAGES in patients with atrial fibrillation : a systematic review and meta-analysis", J Interv Card Electrophysiol, 40, pp.277~284 (2014)
  36. Chang G, "Accuracy of HAS-BLED and other bleeding risk assessment tools in predicting major bleeding events in atrial fibrillation : a network meta-analysis", J Thromb Haemost, 18, pp.791~801 (2020)
  37. Zhu W, "The HAS-BLED score for predicting major bleeding risk in anticoagulated patients with atrial fibrillation : a systematic review and meta-analysis", Clin Cardiol, 38, pp.555~561 (2015)
  38. Berg DD, "Performance of the ABC scores for assessing the risk of stroke or systemic embolism and bleeding in patients with atrial fibrillation in ENGAGE AF-TIMI 48", Circulation, 139, pp.760~771 (2019)
  39. Hijazi Z, "The novel biomarker-based ABC(age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation : a derivation and validation study", Lancet, 387, pp.2302~2311 (2016)
  40. Lip GY, "Bleeding risk assessment in atrial fibrillation : observations on the use and misuse of bleeding risk scores", J Thromb Haemost, 14, pp.1711~1714 (2016)
  41. Hart RG, "Meta-analysis : antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation", Ann Intern Med, 146, pp.857~867 (2007)
  42. De Caterina R, "Vitamin K antagonists in heart disease: current status and perspectives (Section III). Position paper of the ESC Working Group on Thrombosis--Task Force on Anticoagulants in Heart Disease", Thromb Haemost, 110, pp.1087~1107 (2013)
  43. Choi WS, "Optimal international normalized ratio for warfarin therapy in elderly Korean patients with non-valvular atrial fibrillation", Int J Arrhythm, 17, pp.167~173 (2016)
  44. Lee IH, "Underutilization of warfarin for stroke prophylaxis in patients with atrial fibrillation or atrial flutter in Korea", J Cardiol, 66, pp.475~481 (2015)
  45. Wan Y, "Anticoagulation control and prediction of adverse events in patients with atrial fibrillation : a systematic review", Circ Cardiovasc Qual Outcomes, 1, pp.84~91 (2008)
  46. Ki Hong Lee, "Impact of Anticoagulation Intensity in Korean Patients with Atrial Fibrillation: Is It Different from Western Population?", Korean Circulation Journal, 50(2), pp.163~175 (2020), 대한심장학회[DOI]
  47. Amin A, "Estimation of the impact of warfarin's time-in-therapeutic range on stroke and major bleeding rates and its influence on the medical cost avoidance associated with novel oral anticoagulant use-learnings from ARISTOTLE, ROCKET-AF, and RE-LY trials", J Thromb Thrombolysis, 38, pp.150~159 (2014)
  48. Själander S, "Dabigatran, rivaroxaban and apixaban vs. high TTR warfarin in atrial fibrillation", Thromb Res, 167, pp.113~118 (2018)
  49. Proietti M, "Simple decision-making between a vitamin K antagonist and a non-vitamin K antagonist oral anticoagulant : using the SAMe-TT2R2 score", Eur Heart J Cardiovasc Pharmacother, 1, pp.150~152 (2015)
  50. Apostolakis S, "Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin : the SAMe-TT₂R₂ score", Chest, 144, pp.1555~1563 (2013)
  51. Connolly SJ, "Dabigatran versus warfarin in patients with atrial fibrillation", N Engl J Med, 361, pp.1139~1151 (2009)
  52. Patel MR, "Rivaroxaban versus warfarin in nonvalvular atrial fibrillation", N Engl J Med, 365, pp.883~891 (2011)
  53. Granger CB, "Apixaban versus warfarin in patients with atrial fibrillation", N Engl J Med, 365, pp.981~992 (2011)
  54. Giugliano RP, "Edoxaban versus warfarin in patients with atrial fibrillation", N Engl J Med, 369, pp.2093~2104 (2013)
  55. Ruff CT, "Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation : a meta-analysis of randomised trials", Lancet, 383, pp.955~962 (2014)
  56. Wang KL, "Non-vitamin K antagonist oral anticoagulants for stroke prevention in Asian patients with nonvalvular atrial fibrillation : meta-analysis", Stroke, 46, pp.2555~2561 (2015)
  57. Cha MJ, "Effectiveness and safety of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation", Stroke, 48, pp.3040~3048 (2017)
  58. Connolly SJ, "Apixaban in patients with atrial fibrillation", N Engl J Med, 364, pp.806~817 (2011)
  59. Camm AJ, "XANTUS : a real-world, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation", Eur Heart J, 37, pp.1145~1153 (2016)
  60. Carmo J, "Dabigatran in real-world atrial fibrillation. Meta-analysis of observational comparison studies with vitamin K antagonists", Thromb Haemost, 116, pp.754~763 (2016)
  61. Huisman MV, "Two-year follow-up of patients treated with dabigatran for stroke prevention in atrial fibrillation : global registry on long-term antithrombotic treatment in patients with atrial fibrillation(GLORIA-AF)registry", Am Heart J, 198, pp.55~63 (2018)
  62. Lee SR, "Edoxaban in Asian patients with atrial fibrillation : effectiveness and safety", J Am Coll Cardiol, 72, pp.838~853 (2018)
  63. Li XS, "Effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation patients in "real-world" clinical practice. A propensity-matched analysis of 76,940 patients", Thromb Haemost, 117, pp.1072~1082 (2017)
  64. Martínez CAA, "XANTUS-EL : a real-world, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation in Eastern Europe, Middle East, Africa and Latin America", Egypt Heart J, 70, pp.307~313 (2018)
  65. Lee KH, "Optimal dose of dabigatran for the prevention of thromboembolism with minimal bleeding risk in Korean patients with atrial fibrillation", Europace, 19(Suppl 4), pp.iv1~iv9 (2017)
  66. Ingrasciotta Y, "Pharmacokinetics of new oral anticoagulants : implications for use in routine care", Expert Opin Drug Metab Toxicol, 14, pp.1057~1069 (2018)
  67. Lee KH, "Comparison of non-vitamin K antagonist oral anticoagulants and warfarin on clinical outcomes in atrial fibrillation patients with renal dysfunction", Europace, 17(Suppl 2), pp.ii69~ii75 (2015)
  68. Lee SR, "Optimal rivaroxaban dose in Asian patients with atrial fibrillation and normal or mildly impaired renal function", Stroke, 50, pp.1140~1148 (2019)
  69. Siontis KC, "Outcomes associated with apixaban use in patients with end-stage kidney disease and atrial fibrillation in the United States", Circulation, 138, pp.1519~1529 (2018)
  70. Stanton BE, "Comparison of the safety and effectiveness of apixaban versus warfarin in patients with severe renal impairment", Pharmacotherapy, 37, pp.412~419 (2017)
  71. Steinberg BA, "Off-label dosing of non-vitamin K antagonist oral anticoagulants and adverse outcomes : the ORBIT-AF II Registry", J Am Coll Cardiol, 68, pp.2597~2604 (2016)
  72. Yao X, "Non-vitamin K antagonist oral anticoagulant dosing in patients with atrial fibrillation and renal dysfunction", J Am Coll Cardiol, 69, pp.2779~2790 (2017)
  73. 이소령, "Label Adherence for Non-Vitamin K Antagonist Oral Anticoagulants in a Prospective Cohort of Asian Patients with Atrial Fibrillation", Yonsei Medical Journal, 60(3), pp.277~284 (2019), 연세대학교의과대학[DOI]
  74. Lee KN, "Effectiveness and safety of off-label dosing of non-vitamin K antagonist anticoagulant for atrial fibrillation in Asian patients", Sci Rep, 10, pp.1801~ (2020)
  75. Cho MS, "Outcomes after use of standardand low-dose non-vitamin K oral anticoagulants in Asian patients with atrial fibrillation", Stroke, 50, pp.110~118 (2018)
  76. 정보영, "Real-world Data and Recommended Dosage of Non-vitamin K Oral Anticoagulants for Korean Patients", Korean Circulation Journal, 47(6), pp.833~841 (2017), 대한심장학회[DOI]
  77. ACTIVE Writing Group of the ACTIVE Investigators, "Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events(ACTIVE W) : a randomised controlled trial", Lancet, 367, pp.1903~1912 (2006)
  78. ACTIVE Investigators, "Effect of clopidogrel added to aspirin in patients with atrial fibrillation", N Engl J Med, 360, pp.2066~2078 (2009)
  79. Själander S, "Atrial fibrillation patients do not benefit from acetylsalicylic acid", Europace, 16, pp.631~638 (2014)
  80. Lip GY, "The role of aspirin for stroke prevention in atrial fibrillation", Nat Rev Cardiol, 8, pp.602~606 (2011)
  81. Mant J, "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, pp.493~503 (2007)
  82. Holmes DR, "Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation : a randomised non-inferiority trial", Lancet, 374, pp.534~542 (2009)
  83. Reddy VY, "Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation : the ASAP study(ASA plavix feasibility study with watchman left atrial appendage closure technology)", J Am Coll Cardiol, 61, pp.2551~2556 (2013)
  84. Reddy VY, "Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-year follow-up of the PROTECT AF (watchman left atrial appendage system for embolic protection in patients with atrial fibrillation) trial", Circulation, 127, pp.720~729 (2013)
  85. Holmes DR Jr, "Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy : the PREVAIL trial", J Am Coll Cardiol, 64, pp.1~12 (2014)
  86. Boersma LV, "Implant success and safety of left atrial appendage closure with the WATCHMAN device : peri-procedural outcomes from the EWOLUTION registry", Eur Heart J, 37, pp.2465~2474 (2016)
  87. Boersma LV, "Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation : 1-year follow-up outcome data of the EWOLUTION trial", Heart Rhythm, 14, pp.1302~1308 (2017)
  88. Badheka AO, "Utilization and adverse outcomes of percutaneous left atrial appendage closure for stroke prevention in atrial fibrillation in the United States : influence of hospital volume", Circ Arrhythm Electrophysiol, 8, pp.42~48 (2015)
  89. Pison L, "Left atrial appendage closure-indications, techniques, and outcomes : results of the European Heart Rhythm Association Survey", Europace, 17, pp.642~646 (2015)
  90. Price MJ, "Early safety and efficacy of percutaneous left atrial appendage suture ligation:results from the U.S. transcatheter LAA ligation consortium", J Am Coll Cardiol, 64, pp.565~572 (2014)
  91. Fauchier L, "Device-related thrombosis after percutaneous left atrial appendage occlusion for atrial fibrillation", J Am Coll Cardiol, 71, pp.1528~1536 (2018)
  92. Lakkireddy D, "Short and long-term outcomes of percutaneous left atrial appendage suture ligation : results from a US multicenter evaluation", Heart Rhythm, 13, pp.1030~1036 (2016)
  93. van Laar C, "Thoracoscopic left atrial appendage clipping : a multicenter cohort analysis", JACC Clin Electrophysiol, 4, pp.893~901 (2018)
  94. Healey JS, "Left atrial appendage occlusion study(LAAOS) : results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke", Am Heart J, 150, pp.288~293 (2005)
  95. Whitlock RP, "Left atrial appendage occlusion study II(LAAOS II)", Can J Cardiol, 29, pp.1443~1447 (2013)
  96. Tsai YC, "Surgical left atrial appendage occlusion during cardiac surgery for patients with atrial fibrillation : a meta-analysis", Eur J Cardiothorac Surg, 47, pp.847~854 (2015)
  97. Aryana A, "Association between incomplete surgical ligation of left atrial appendage and stroke and systemic embolization", Heart Rhythm, 12, pp.1431~1437 (2015)
  98. Gillinov AM, "Surgical ablation of atrial fibrillation during mitral-valve surgery", N Engl J Med, 372, pp.1399~1409 (2015)
  99. Whitlock R, "Rationale and design of the left atrial appendage occlusion study(LAAOS)III", Ann Cardiothorac Surg, 3, pp.45~54 (2014)
  100. Chao TF, "Oral anticoagulation in very elderly patients with atrial fibrillation : a nationwide cohort study", Circulation, 138, pp.37~47 (2018)
  101. Nielsen PB, "Effectiveness and safety of reduced dose non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study", BMJ, 356, pp.j510~ (2017)
  102. Larsen TB, "Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study", BMJ, 353, pp.i3189~ (2016)
  103. Tilz RR, "Left atrial appendage occluder implantation in Europe: indications and anticoagulation post-implantation. Results of the European Heart Rhythm Association Survey", Europace, 19, pp.1737~1742 (2017)
  104. Ogawa H, "Progression from paroxysmal to sustained atrial fibrillation is associated with increased adverse events", Stroke, 49, pp.2301~2308 (2018)
  105. Potpara TS, "A 12-year follow-up study of patients with newly diagnosed lone atrial fibrillation : implications of arrhythmia progression on prognosis : the Belgrade atrial fibrillation study", Chest, 141, pp.339~347 (2012)
  106. Mahajan R, "Subclinical device-detected atrial fibrillation and stroke risk : a systematic review and meta-analysis", Eur Heart J, 39, pp.1407~1415 (2018)
  107. Brambatti M, "Temporal relationship between subclinical atrial fibrillation and embolic events", Circulation, 129, pp.2094~2099 (2014)
  108. Boriani G, "Device-detected atrial fibrillation and risk for stroke : an analysis of >10, 000patients from the SOS AF project(stroke prevention strategies based on atrial fibrillation information from implanted devices)", Eur Heart J, 35, pp.508~516 (2014)
  109. Freedman B, "Screening for atrial fibrillation : a report of the AF-SCREEN international collaboration", Circulation, 135, pp.1851~1867 (2017)
  110. Freedman B, "Management of atrial high-rate episodes detected by cardiac implanted electronic devices", Nat Rev Cardiol, 14, pp.701~714 (2017)
  111. Camm AJ, "Atrial high-rate episodes and stroke prevention", Europace, 19, pp.169~179 (2017)
  112. Boriani G, "Detection of new atrial fibrillation in patients with cardiac implanted electronic devices and factors associated with transition to higher device-detected atrial fibrillation burden", Heart Rhythm, 15, pp.376~383 (2018)
  113. Pastori D, "Incidence of bleeding in patients with atrial fibrillation and advanced liver fibrosis on treatment with vitamin K or non-vitamin K antagonist oral anticoagulants", Int J Cardiol, 264, pp.58~63 (2018)
  114. Kuo L, "Liver cirrhosis in patients with atrial fibrillation: would oral anticoagulation have a net clinical benefit for stroke prevention?", J Am Heart Assoc., 6, pp.e005307~ (2017)
  115. Lee SR, "Direct oral anticoagulants in patients with atrial fibrillation and liver disease", J Am Coll Cardiol, 73, pp.3295~3308 (2019)
  116. Staerk L, "Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation:nationwide cohort study", BMJ, 351, pp.h5876~ (2015)
  117. Eckman MH, "Moving the tipping point : the decision to anticoagulate patients with atrial fibrillation", Circ Cardiovasc Qual Outcomes, 4, pp.14~21 (2011)
  118. Proietti M, "Major S outcomes in atrial fibrillation patients with one risk factor : impact of time in therapeutic range observations from the PORTIF trials", Am J Med, 129, pp.1110~1116 (2016)
  119. Lip GY, "Should Patients with atrial fibrillation and 1 stroke risk factor(CHA2DS2-VASc score 1 in men, 2 in women)be anticoagulated? Yes : even 1 stroke risk factor confers a real risk of stroke", Circulation, 133, pp.1498~1503 (2016)
  120. Lip GY, "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, pp.263~272 (2010)
  121. Kim D, "Ideal blood pressure in patients with atrial fibrillation", J Am Coll Cardiol, 72, pp.1233~1245 (2018)
  122. Nielsen PB, "Stroke and thromboembolic event rates in atrial fibrillation according to different guideline treatment thresholds : a nationwide cohort study", Sci Rep, 6, pp.27410~ (2016)
  123. Pisters R, "A novel user-friendly score(HAS-BLED)to assess 1-year risk of major bleeding in patients with atrial fibrillation : the Euro Heart Survey", Chest, 138, pp.1093~1100 (2010)
  124. Böhm M, "Changes in renal function in patients with atrial fibrillation : an analysis from the RE-LY trial", J Am Coll Cardiol, 65, pp.2481~2493 (2015)
  125. Hijazi Z, "Efficacy and safety of apixaban compared with warfarin in patients with atrial fibrillation in relation to renal function over time : insights from the ARISTOTLE randomized clinical trial", JAMA Cardiol, 1, pp.451~460 (2016)
  126. Potpara TS, "Reliable identification of"truly low"thromboembolic risk in patients initially diagnosed with"lone"atrial fibrillation : the Belgrade atrial fibrillation study", Circ Arrhythm Electrophysiol, 5, pp.319~326 (2012)
  127. Weijs B, "Idiopathic atrial fibrillation patients rapidly outgrow their low thromboembolic risk : a 10-year follow-up study", Neth Heart J, 27, pp.487~497 (2019)
  128. Chao TF, "Incident co-morbidities in patients with atrial fibrillation initially with a CHA2DS2-VASc score of 0(males)or 1(females) : implications for reassessment of stroke risk in initially 'low-risk' patients", Thromb Haemost, 119, pp.1162~1170 (2019)
  129. Clarkesmith DE, "Educational intervention improves anticoagulation control in atrial fibrillation patients: the TREAT randomised trial", PLoS One, 8, pp.e74037~ (2013)
  130. Teiger E, "Percutaneous left atrial appendage closure is a reasonable option for patients with atrial fibrillation at high risk for cerebrovascular events", Circ Cardiovasc Interv., 11, pp.e005841~ (2018)
  131. Hart RG, "Stroke with intermittent atrial fibrillation:incidence and predictors during aspirin therapy. Stroke prevention in atrial fibrillation investigators", J Am Coll Cardiol, 35, pp.183~187 (2000)
  132. Saw J, "Early Canadian multicenter experience with WATCHMAN for percutaneous left atrial appendage closure", J Cardiovasc Electrophysiol, 28, pp.396~401 (2017)
  133. Martin Gutierrez E, "Beneficial effect of left atrial appendage closure during cardiac surgery : a meta-analysis of 280 585 patients", Eur J Cardiothorac Surg, 57, pp.252~262 (2020)

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