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2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation Laurent Macle, MD, John Cairns, MD, Kori Leblanc, PharmD, Teresa Tsang, MD, Allan Skanes, MD, Jafna L. Cox, MD, Jeff S. Healey, MD, Alan Bell, MD, Louise Pilote, MD, Jason G. Andrade, MD, L. Brent Mitchell, MD, Clare Atzema, MD, David Gladstone, MD, Mike Sharma, MD, Subodh Verma, MD, Stuart Connolly, MD, Paul Dorian, MD, Ratika Parkash, MD, Mario Talajic, MD, Stanley Nattel, MD, Atul Verma, MD Canadian Journal of Cardiology Volume 32, Issue 10, Pages (October 2016) DOI: /j.cjca Copyright © Terms and Conditions
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Figure 1 The simplified “Canadian Cardiovascular Society Algorithm” (“CHADS-65”) for deciding which patients with atrial fibrillation (AF) or atrial flutter should receive oral anticoagulation (OAC) therapy. It recommends OAC for most patients ≥ 65 years of age and for younger patients with a Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack (CHADS2) score ≥ 1; aspirin (acetylsalicylic acid; ASA) for patients < 65 years of age with a CHADS2 score = 0 with arterial vascular disease (coronary, aortic, or peripheral); and no antithrombotic therapy for patients < 65 years of age with a CHADS2 score = 0 and no arterial vascular disease. Bleeding risks should be modified whenever possible. A non-vitamin K antagonist oral anticoagulant (NOAC) is recommended in preference to warfarin for OAC therapy in NVAF patients. CAD, coronary artery disease; INR, international normalized ratio; NSAID, nonsteroidal anti-inflammatory drug; TIA, transient ischemic attack. Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright © Terms and Conditions
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Figure 2 A summary of our recommendations for the management of antithrombotic therapy in patients with concomitant atrial fibrillation (AF) and an indication for primary coronary artery disease (CAD) prevention or stable CAD/arterial vascular disease. ASA, acetylsalicylic acid (aspirin); CHADS2, Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant. Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright © Terms and Conditions
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Figure 3 A summary of our recommendations for the management of antithrombotic therapy in patients with atrial fibrillation (AF) and recent percutaneous coronary intervention (PCI). ASA, acetylsalicylic acid (aspirin); CHADS2, Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant. Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright © Terms and Conditions
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Figure 4 A summary of our recommendations for the management of antithrombotic therapy in patients with atrial fibrillation (AF) in association with Non-ST-elevation acute coronary syndrome (NSTEACS) or ST-elevation myocardial infarction (STEMI). ASA, acetylsalicylic acid (aspirin); CHADS2, Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant; PCI, percutaneous coronary intervention. Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright © Terms and Conditions
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