Antithrombotic therapy in patients with chronic atrial fibrillation

Antithrombotic therapy for patients with chronic atrial fibrillation should comprehensively consider embolism risk, bleeding risk and individual conditions, balance benefits and risks, select anticoagulant or antiplatelet therapy according to scores and risk factors, evaluate bleeding risk and monitor treatment process.

Antithrombotic therapy (e.g. warfarin, new oral anticoagulants) to reduce the risk of embolism. For patients with CHA 2DS2-VASc score = 1, if more than one risk factor is present

Oral anticoagulant therapy is also recommended for patients aged ≥ 75 years, hypertension, diabetes mellitus, heart failure, left ventricular dysfunction, and antithrombotic therapy with antiplatelet agents (e.g. aspirin or clopidogrel) may be considered for patients at high risk of bleeding or unwilling to receive anticoagulant therapy. Before antithrombotic therapy, the bleeding risk of patients should be evaluated in detail, including previous bleeding history, age, liver and kidney function, concomitant medications, etc. At the same time, attention should be paid to possible bleeding adverse reactions during anticoagulation therapy, such as gingival bleeding, epistaxis, gastrointestinal bleeding, etc. In addition, patients receiving antithrombotic therapy should follow the doctor's advice, take medicine on time, and regularly review, including coagulation function, blood routine, etc., so as to adjust the treatment plan in time. In short, antithrombotic therapy for patients with chronic atrial fibrillation should be individualized, weighing benefits and risks according to the specific conditions of patients, selecting appropriate treatment plan, and closely monitoring bleeding and embolism risks during treatment. At the same time, patients should also actively cooperate with doctors' treatment and maintain a healthy lifestyle, such as smoking cessation and alcohol restriction, blood pressure and blood sugar control, so as to reduce the risk of atrial fibrillation related complications.