{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:34:10Z","timestamp":1760142850150,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mefasa Farma (Grupo Profarmaco)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.<\/jats:p>","DOI":"10.3390\/jcm13020314","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T07:38:31Z","timestamp":1704440311000},"page":"314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Central American and Caribbean Consensus Document for the Optimal Management of Oral Anticoagulation in Patients with Non-Valvular Atrial Fibrillation Endorsed by the Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention"],"prefix":"10.3390","volume":"13","author":[{"given":"Fernando","family":"Wyss","sequence":"first","affiliation":[{"name":"Cardiovascular Services and Technology of Guatemala, CARDIOSOLUTIONS, Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6135-7685","authenticated-orcid":false,"given":"Vivencio","family":"Barrios","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Ramon y Cajal, School of Medicine, Alcala University, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9651-916X","authenticated-orcid":false,"given":"M\u00e1xima","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Cardiologist-Internal Medicine, Medicine Autonomous University, Santo Domingo 10105, Dominican Republic"},{"name":"Cardiometabolic Unity, The Hub Innovation and Investigation of the Iberoamerican University, UNIBE, Santo Domingo 10203, Dominican Republic"},{"name":"Lipid Master National Lipid Association, Jacksonville, FL 32216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Ramos","sequence":"additional","affiliation":[{"name":"Cardiology Department, Presidente Estrella Ure\u00f1a Hospital, Santiago de los Caballeros, Salvador B. Gautier Hospital, Santo Domingo 10514, Dominican Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospiten Santo Domingo, Aut\u00f3noma de Santo Domingo University, Santo Domingo 1355, Dominican Republic"},{"name":"American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Cardiology Department, Herrera Llerandi Hospital, Guatemala City 01010, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Rodas","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Guatemalan Association of Cardiology, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City 01010, Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Castillo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Max Peralta Hospital, Costa Rica University Cartago, Cartago 30101, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4367-549X","authenticated-orcid":false,"given":"Daniel","family":"Quesada","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital San Vicente de Paul, Universidad de Costa Rica, Heredia 40101, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Enrique","family":"Franco","sequence":"additional","affiliation":[{"name":"Cardiology Department, Surgical and Oncological Medical Hospital, Instituto Salvadore\u00f1o del Seguro Social, Escalon Medical Center, San Salvador 1101, El Salvador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Ventura","sequence":"additional","affiliation":[{"name":"Cardiology Department, Instituto Salvadore\u00f1o del Seguro Social, San Salvador 1101, El Salvador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio Peralta","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Somoza","sequence":"additional","affiliation":[{"name":"Cardiology Department, CEMESA Hospital, San Pedro Sula 21102, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel Arguello","family":"Montealegre","sequence":"additional","affiliation":[{"name":"Cardiology Department, Viv\u00edan Pellas Hospital, Managua 11044, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Meneses","sequence":"additional","affiliation":[{"name":"Cardiology Department, Del Valle Cardiologic Clinique, Nacional Aut\u00f3noma of Nicaragua University, Managua 14145, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Pichel","sequence":"additional","affiliation":[{"name":"Cardiology Department, Paitilla Hospital, University of Panam\u00e1, Paitilla 06001, Panama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osiris","family":"Valdez","sequence":"additional","affiliation":[{"name":"American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala"},{"name":"Cardiology Department, Central Romana Hospital, La Romana 22000, Dominican Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. 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