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New anticoagulants should be considered for atrial fibrillation, says NICE

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g313 (Published 21 January 2014) Cite this as: BMJ 2014;348:g313
  1. Ingrid Torjesen
  1. 1 London

GPs should no longer automatically prescribe warfarin as the first line treatment for atrial fibrillation but weight up its risks and benefits against those of the newer anticoagulants, the UK National Institute for Health and Care Excellence (NICE) has said in a review of its guidance on managing the condition.

NICE’s draft update of its guideline on atrial fibrillation also proposes other wide ranging changes to management, including GP’s routine use of risk calculation scores for stroke and bleeding when assessing and monitoring patients; rate rather than rhythm control as the first line approach; and wider use of non-pharmacological techniques such as electrical cardioversion and ablation.

Patients with atrial fibrillation have a fivefold increased risk of stroke, so preventing stroke is …

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