[Challenges of long-term anticoagulation in women: is heart failure relevant?].

Abstract

Women have an increased risk of stroke and peripheral embolization in atrial fibrillation (AF), which is in part associated with a higher prevalence of comorbidities, including heart failure (HF). Clinical outcomes of anticoagulant therapy with vitamin K antagonists (VKA) are often unsatisfactory in women regardless of age largely due to a higher risk of unstable anticoagulation compared with men. Non-vitamin K oral anticoagulants (NOAC) are increasingly used for prevention of stroke in patients with nonvalvular AF appear to be particularly beneficial in women overcoming adverse events related to unstable anticoagulation. The current review highlights problems of anticoagulation in women with AF and HF in the era of NOAC.