PDF(Pubmed)
Abstract：
Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.
摘要：
心房颤动（AF）是成人最常见的心律失常。广泛建议使用口服抗凝剂（OAC）预防缺血风险，目前的临床指南推荐直接口服抗凝药(DOACs)作为卒中预防的优先选择疗法.然而,目前尚无专门针对和适应中美洲和加勒比地区背景的房颤患者OAC最佳管理的临床实践指南或推荐文件.这项类似Delphi的研究的目的是应对该地理区域非瓣膜性AF患者的OAC管理中可能出现的疑问。在对文献进行系统回顾的基础上进行了共识项目，推荐的类似于ADOLOPMENT的方法，和两轮德尔菲调查的应用。在第一轮中，评估了31项建议，达成了30项共识，其中，10一致同意该研究评估了各种情境建议中的专家意见，以优化非瓣膜性心房颤动（NVAF）患者的DOAC管理。在与抗凝适应症相关的临床实践指南（CPG）声明上存在广泛共识，患者随访,抗凝治疗并发症，COVID-19的管理和预防，和心脏干预。
