Patients with atrial fibrillation and low risk of stroke - do they really need anticoagulation?

Patients with atrial fibrillation and low risk of stroke - do they really need anticoagulation? Pol Arch Med Wewn. 2015 Aug 26; Authors: Trusz-Gluza M, Filipecki A, Urbańczyk-Świć D Abstract Atrial fibrillation (AF) significantly increases risk of thromboembolic events, in particular the risk of stroke. Anticoagulation therapy reduces this risk and the treatment should be lifelong. However, the risk in patients with non-valvular AF is not equally distributed. There are patients at low risk. Assessment of the thromboembolic risk according to guidelines is mandatory, most frequently CHA2DS2-VASc scheme is used. In the large group with the CHA2DS2-VASc-0 (females 1) the annual risk of stroke was 0.49%, ischemic stroke 0.43%, on the other side the risk of bleeding was 1.08%, intracranial bleeding 0.15%. Total mortality was 3.87%/year. In patients on wafarin the frequency of ischemic stroke was similar. This low risk patients did not benefit from anticoagulation. The low risk group could be also defined as the patients younger than 65 years of age without structural cardiovascular disease regardless of gender. They represent 6-10  of patients with non-valvular AF. Thromboembolic risk in patients with score 1 (female 2) is more controversial. This population was assessed in several recently published cohort studies. In Sweden the risk was found to be low. On contrary, in Denmark and Taiwan it was significantly higher. Eckman analysis f...
Source: Polskie Archiwum Medycyny Wewnetrznej - Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research