Optimizing Anticoagulation in Atrial Fibrillation: Guideline Updates, Emerging Therapies, and Practical Implementation

This activity was originally presented at the 2026 Cardiology Day of Education.

Endorsed by the American College of Cardiology

Disclaimer: ACCF makes no guarantees or promises regarding the contents of PTCE’s program.

Program Information

Anticoagulation remains the cornerstone of stroke prevention in patients with atrial fibrillation, yet a substantial residual risk of ischemic events persists due to underuse, suboptimal dosing, and treatment interruptions driven by bleeding concerns. Even with current standard-of-care therapies, including direct oral anticoagulants (DOACs), many patients remain untreated or undertreated. These gaps highlight the need for more targeted approaches, including emerging Factor XI/XIa inhibitors, which selectively inhibit the intrinsic coagulation pathway and are being investigated for their potential to reduce thrombotic risk with a lower risk of bleeding. This session will review the epidemiology and pathophysiology of thromboembolism, current guideline recommendations for risk stratification and anticoagulant selection, and practical strategies for pharmacist-led care. Emphasis will be placed on consistent application of guideline-directed risk assessment tools and interpretation of clinical trial data for investigational therapies to support individualized, safe, and effective care. Patient cases will be included to reinforce real-world application and prepare pharmacists for the evolving anticoagulation landscape.

Target audience: Community pharmacists
Type of activity: Application
Release date: June 25, 2026
Expiration date: June 25, 2027
Learner level: Foundational, Intermediate
Time to complete activity: 1.5 hours
Fee: Free

Educational Objectives

At the completion of this activity, participants will be able to:

• Explain the pathophysiology of thromboembolism in atrial fibrillation and its relationship to stroke risk
• Differentiate the mechanisms of action, efficacy, and safety profiles of current anticoagulants and emerging Factor XI/XIa inhibitors
• Factor guideline-directed strategies for stroke and systemic embolism prevention into anticoagulation management, including risk stratification and therapy selection
• Manage individualized anticoagulation plans for patients with atrial fibrillation using evidence-based recommendations and principles of shared decision-making

Accreditation

Pharmacy Times Continuing Education™ is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.5 contact hours (0.15 CEU) under the ACPE universal activity number 0290-0000-26-184-H01-P. The activity is available for CE credit through June 25, 2027.

Instructions for Completing the Activity and Receiving CPE Credit

To receive CPE credit, participants must complete the pretest, view the activity in its entirety, complete the posttest, and complete the online activity evaluation. After successful completion of the online activity evaluation, you can submit your credit to CPE Monitor. You may view your credit within 48 hours at www.mycpemonitor.net. All participants must request credit before the activity expiration date. CE credit will not be issued after this date.

Faculty

Stephanie Dwyer, PharmD, BCCP, has the following relevant financial relationship with ineligible companies to disclose:

Consultant: Bayer

Pharmacy Times Continuing Education™ Planning Staff—Jim Palatine, RPh, MBA; Rose Buszka, PharmD, BCPS, CHCP; Kylie Ferrentino; Brianna Winters; and Chloe Taccetta have no financial relationships with ineligible companies to disclose.

Any relevant financial relationships listed for these individuals have been mitigated.

At least one anonymous peer reviewer was used as part of content validation and conflict resolution. The peer reviewer has no relevant financial relationships with ineligible companies to disclose.

Educational Disclaimer

Continuing professional education activities are offered solely for educational purposes and do not constitute any form of professional advice or referral. Discussions concerning drugs, dosages, and procedures may reflect the clinical experience of the author(s) or be derived from the professional literature or other sources and may suggest uses that are investigational in nature and not approved by the labeling or indications. Participants are encouraged to refer to primary references or full prescribing information resources.

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