Hospital Virgen de la Victoria, Campus de Teatinos, S/N, Puerto de la Torre, 29010, Málaga.
Hospital de la Santa Creu i Sant Pau, C/de Sant Quintí, 89, Horta-Guinardó, 08025, Barcelona.
Future Cardiol. 2024;20(13):695-708. doi: 10.1080/14796678.2024.2343550. Epub 2024 Oct 22.
Management of oral anticoagulation (OAC) can be challenging, such as in complex cases of nonvalvular atrial fibrillation (NVAF). A Delphi study comprising two rounds was used for gathering expert opinion through an online questionnaire (83 items grouped in 8 dimensions) on OAC management in specific clinical settings. Consensus was reached for 79 items (95%) in round 1. Experts recommended direct-acting oral anticoagulants (DOACs) for pericardioversion, uninterrupted OAC for catheter ablation, and dual therapy with a DOAC and clopidogrel after percutaneous coronary intervention. They also recommended restarting OAC with a DOAC after an intracranial haemorrhage. The expert-based recommendations obtained may contribute to standardizing and guiding the management of OAC in complex clinical situations in cardiology.
口服抗凝药物（OAC）的管理具有一定挑战性，例如在非瓣膜性心房颤动（NVAF）等复杂情况下。本研究采用两轮 Delphi 法，通过在线问卷（83 项，分为 8 个维度）收集专家意见，内容涉及特定临床情况下的 OAC 管理。第一轮中，79 项（95%）达成共识。专家建议在心脏复律时使用直接口服抗凝药物（DOACs）、在导管消融时不间断使用 OAC、经皮冠状动脉介入治疗后采用 DOAC 和氯吡格雷双联治疗。专家还建议在颅内出血后重启 DOAC 治疗。本研究获得的专家建议可能有助于规范和指导心血管领域复杂临床情况下 OAC 的管理。
