@article{1e58241d8bab4bc6bc843da0519a0483,
title = "Is bleeding a necessary evil? the inherent risk of antithrombotic pharmacotherapy used for stroke prevention in atrial fibrillation",
abstract = "Current European atrial fibrillation (AF) guidelines have assigned a strong recommendation for the initiation of antithrombotic therapy to prevent thromboembolism in all but those AF patients at low risk (or with contraindications). Furthermore, the selection of antithrombotic therapy is based on the absolute risks of thromboembolism and bleeding, and the relative risk and benefit for a given patient. By their very mechanism of action, antithrombotic agents used for stroke prevention in AF will potentially increase the risk of bleeding events. Moreover, the introduction of novel oral anticoagulation agents have introduced new, hitherto ill-defined, deficiencies in the authors' knowledge with respect to anticoagulation monitoring, availability of direct antidotes, drug-drug interactions and the ability to appropriately control and reverse their actions if bleeding events occur. The authors present a comprehensive review on all aspects of bleeding related to currently licensed antithrombotic agents used for stroke prevention in patients with AF.",
keywords = "apixaban, aspirin, atrial fibrillation, clopidogrel, dabigatran, novel oral anticoagulant, rivaroxaban, stroke, thromboembolism, warfarin",
author = "Aung Myat and Yousif Ahmad and Shouvik Haldar and Tantry, {Udaya S.} and Redwood, {Simon R.} and Gurbel, {Paul A.} and Lip, {Gregory Y.H.}",
note = "Funding Information: PA Gurbel serves as a consultant for Daiichi-Sankyo, Lilly, Pozen, Bayer, AstraZeneca, Accumetrics, Nanosphere, Sanofi-Aventis, Boehringer Ingelheim, Merck, Medtronic, CSL and Haemonetics; receiving grants from the National Institutes of Health, Daiichi-Sankyo, Lilly, CSL, AstraZeneca, Sanofi-Aventis, Haemoscope, Medtronic, Harvard Clinical Research Institute and Duke Clinical Research Institute; receiving payment for lectures, including service on speakers bureaus, from Lilly, Daiichi-Sankyo, Nanosphere, Sanofi-Aventis, Merck and Iverson Genetics; receiving payment for development of educational presentations from Schering-Plough, the Discovery Channel and Pri-Med; holding stock or stock options in Merck, Medtronic and Pfizer. US Tantry reports receiving payment for lectures and receiving travel support from Accumetrics. GYH Lip has served as a consultant for Bayer, Astellas, Merck, Sanofi, BMS/ Pfizer, Daiichi-Sankyo, Biotronik, Portola and Boehringer Ingelheim and has been on the speaker{\textquoteright}s bureau for Bayer, BMS/Pfizer, Boehringer Ingelheim and Sanofi-Aventis. A Myat is supported by the Department of Health via the National Institute for Health Research comprehensive Biomedical Research Centre award to Guy{\textquoteright}s & St Thomas{\textquoteright} NHS Foundation Trust in partnership with King{\textquoteright}s College London and King{\textquoteright}s College Hospital NHS Foundation Trust along with a British Heart Foundation Clinical Research Training Fellowship (Grant Number FS/11/70/28917). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.",
year = "2013",
month = aug,
doi = "10.1586/14779072.2013.815423",
language = "English (US)",
volume = "11",
pages = "1029--1049",
journal = "Expert review of cardiovascular therapy",
issn = "1477-9072",
publisher = "Expert Reviews Ltd.",
number = "8",
}