Master of Science in Nursing (MSN) Student Scholarship

Date Written

Summer 2015

Document Type


Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo


Cardiac Arrhythmia, Coagulation Cascade

Subject Categories

Cardiovascular Diseases | Medical Pathology | Medicine and Health Sciences | Nursing


Atrial fibrillation (afib) is the most common sustained cardiac arrhythmia and second most common cardiovascular condition in adults in the United States (Zarraga & Kron, 2012). •2.2 million affected, increases risk of stroke 4 to 6 times (National Institute of Neurological Disorders and Stroke [NINDS], 2015). •Vitamin K antagonists (VKAs) have been mainstay of therapy for over 60 years (King, Holley& Moores, 2013). •Limitations with VKAs such as variability in response, need for frequent lab draws, food and drug interactions which decrease patients adherence and under prescribing by physicians (Halperin & Goyette, 2012). •Novel oral anticoagulants (NOACs) have been approved by FDA over last 5 years for management of non-valvular afib and stroke prevention. •Non-valvular afib is afib in the absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair (Koza, 2014). •NOACs are direct thrombin inhibitors and Xa inhibitors that intend to improve patient adherence, simplify anticoagulation, and overcome barriers to long term therapy. •Important to know what population is appropriate, what are bleeding risks, reversal agents, cost, overall benefit to NOACs versus VKAs.



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