Benefit of Anticoagulation Unlikely in Patients With Atrial Fibrillation and a CHA(2)DS(2)-VASc Score of 1
2015 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 65, no 3, 225-232 p.Article in journal (Refereed) Published
BACKGROUND Patients with atrial fibrillation (AF) and >= 1 point on the stroke risk scheme CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category) are considered at increased risk for future stroke, but the risk associated with a score of 1 differs markedly between studies. OBJECTIVES The goal of this study was to assess AF-related stroke risk among patients with a score of 1 on the CHA(2)DS(2)-VASc. METHODS We conducted this retrospective study of 140,420 patients with AF in Swedish nationwide health registries on the basis of varying definitions of "stroke events." RESULTS Using a wide "stroke" diagnosis (including hospital discharge diagnoses of ischemic stroke as well as unspecified stroke, transient ischemic attack, and pulmonary embolism) yielded a 44% higher annual risk than if only ischemic strokes were counted. Including stroke events in conjunction with the index hospitalization for AF doubled the long-term risk beyond the first 4 weeks. For women, annual stroke rates varied between 0.1% and 0.2% depending on which event definition was used; for men, the corresponding rates were 0.5% and 0.7%. CONCLUSIONS The risk of ischemic stroke in patients with AF and a CHA(2)DS(2)-VASc score of 1 seems to be lower than previously reported. (C) 2015 by the American College of Cardiology Foundation.
Place, publisher, year, edition, pages
2015. Vol. 65, no 3, 225-232 p.
epidemiology, oral anticoagulation, stroke
Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:uu:diva-245359DOI: 10.1016/j.jacc.2014.10.052ISI: 000348046200001PubMedID: 25614418OAI: oai:DiVA.org:uu-245359DiVA: diva2:791368