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

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.