An alarming growth of AF population – How to use oral anticoagulants safely

The lifetime risk of atrial fibrillation (AF) is known to be 1 in 7 in Asian general populations aged > 20 years, and the prevalence is growing with the increase in aged people in developed countries. AF, changing a lot more than just one of the arrhythmias, becomes one of the burdens for society via decreasing the productivity and economic efficiency of the society through AF-related stroke. Although the development of multiple direct oral anticoagulants have contributed to the stroke prevention in recent years, knowledge gaps exist between the randomized controlled trials (RCTs) and the real world including aged population with CKD, multiple morbidities, and polypharmacy, who have been excluded from RCTs and also are at a high risk for major bleedings under anticoagulants. Moreover, real world data with anticoagulants have shown a variety of results making our situations more complex. In this symposium, we will discuss how to use oral anticoagulants safely to the increasing variety and number of AF population, hopefully without stresses on patients, patients’ family and physicians.