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Beroertepreventie in atriumfibrilleren (SPAF) in eerstelijnszorg: EPCCS consensusdocument

2 mrt. 2015 - nieuws

Europese huisartsen bespraken, in het kader van een European Primary Care Cardiovascular Society (EPCCS) expert meeting, de ontwikkelingen in het SPAF-veld en de gevolgen daarvan voor de eerstelijnszorg en stelden een praktisch document op om huisartsen te begeleiden bij het verlenen van optimale zorg aan patiënten met atriumfibrilleren.

Download het EPCCS consensus document hieronder of bezoek de EPCCS-website.

 

EPCCS SPAF Consensus 2015.pdf (0,8MB)EPCCS SPAF Consensus 2015.pdf (0,8MB)



Abstract

 

Background

Atrial fibrillation affects 1-2% of the general population and 10% of those over 75 and is responsible for around a quarter of all strokes. These strokes are largely preventable by the use of anticoagulation therapy, though many eligible patients are not treated appropriately. Recent clinical trials have added to the evidence base on stroke prevention and international clinical guidelines have been updated.
 

Design

Consensus practical recommendations from primary care physicians with an interest in vascular disease and vascular specialists.
 

Methods

Focussed all-day meeting, with presentation of summary evidence under each section of this guidance and review of European guidelines on stroke prevention in atrial fibrillation, generated a draft document, which then underwent 3 cycles of revision and debate before all panel members agreed with the consensus statements.
 

Results

Six areas were identified that included how to identify patients with atrial fibrillation, how to determine their stroke risk and whether to recommend modification of this risk, and what management options are available, with practical recommendations on maximising benefit and minimising risk if anticoagulation is recommended and the reasons why antiplatelet therapy is no longer recommended. The summary evidence is presented for each area and simple summary recommendations are highlighted, with areas of remaining uncertainty listed.
 

Conclusions

Atrial fibrillation related stroke is a very major public health priority for most health systems. This practical guidance can assist generalist community physicians to translate the large evidence base for this major cause of preventable stroke and implement this at a local level. The guidance is slightly more conservative guidance on who to treat.

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Een verkorte versie van dit artikel werd op 20 Februari gepubliceerd op ejpc.sagepub.com (DOI: 10.1177/2047487315571890).
The final, definitive version of this paper has been published in European Journal of Preventive Cardiology, 0/0, Feb/2014 by SAGE Publications Ltd, All rights reserved. © The European Society of Cardiology.