Anticoagulation thresholds and reversal agents in atrial fibrillation
THE CONTEXT
In atrial fibrillation, stroke risk scoring guides anticoagulation. The passage also describes the benefit and bleeding risk of anticoagulation and reversal options for life-threatening bleeding.
Thresholds and expected effects
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Anticoagulation should be considered at a CHA₂DS₂-VA score of 1 and is recommended at a score of 2 or more.
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Anticoagulation reduces stroke risk by around two-thirds, with an annual major bleeding risk of around 1%.
Reversal of life-threatening bleeding
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Prothrombin complex concentrates and other reversal agents can be used for life-threatening bleeding in patients taking direct oral anticoagulants.