NOACs and AF: the Edge of Tomorrow course

NOACs and AF: the Edge of Tomorrow course will cover the haematological and medical perspectives of stroke prevention in atrial fibrillation.

Prescribing for stroke prevention in AF has become much more complicated with the arrival of novel oral anticoagulants.

NICE guidelines have delivered a new tool kit for assessment that allow us to put the patient on a risk map between bleeding and thrombosis.

While trials have shown non inferiority with potential superiority of some NOACs in specific doses, the wider application of these drugs reveals new side effects, dilemmas and unexpected complications.

However, in some sub groups there is still insufficient data for firm recommendation.

Identification of the patient with AF and timely intervention to prevent a devastating stroke is key.

Relevant for GPs and hospital doctors, we will be running this half-day course later in the year. To express interest in attending, email admin@cambridgemedicine.org.uk with your details.

The course is run by Dr Martin Besser, consultant haematologist, and Dr Kayvan Khadjooi, consultant stroke physician, both of Addenbrooke’s Hospital.

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Speaker Programme

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9.30am-10.15am Atrial Fibrillation:The Tell Tale Heart Dr Kayvan Khadjooi

Dr Khadjooi will explain the importance of Atrial Fibrillation as a risk factor for stroke and the burden of AF on healthcare. The challenges in screening, risk stratification and options for anticoagulation will be discussed together with a review of recent NICE guidelines. The medical and medico-legal consequences of not anticoagulating AF patients will also be presented using some real cases.

10.15am-11am NOACs: All Change Please? Dr Martin Besser

Dr Besser will present a brief history of the development of NOACs, as well as practical dosing advice and reversal options. The session will also explore the unexpected pitfalls in NOAC use: specifically the interpretation of laboratory tests and thrombophilia testing, explaining when and where haemorrhaging can help. It will answer questions like: which tests can I expect from the laboratory? When is the involvement of a haematologist useful? As well as focusing on differential diagnosis, PPCI, thrombolysis and the latest medical treatments to optimise your patient will also be reviewed.

11.15am-12pm Weighing Up the Risks and Benefits Dr Kayvan Khadjooi

This practical session will focus on stroke prevention and review the NICE guidelines. It will discuss the long term outcomes of treatment with NOACs and specifically tackle when to choose NOACs over warfarin. Other licensed indication uses and off label uses will also be explained

12pm-12.45pm Cases: The Good; the Bad; and the Ugly Dr Martin Besser

Case discussions regarding: interpretation of abnormal coagulation tests, overdose on NOACs, decisions regarding thrombolysis in patients on NOACs, treatment of AF in TIA, and anticoagulation in non-compliant patients.

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