Age, Ethnicity, and Stroke Risk in Patients With Atrial Fibrillation Another Stitch in the Patchwork ∗

The frequency with which clinicians encounter patients with nonvalvular atrial fibrillation (AF) and its association with ischemic stroke make estimation of the risk borne by individuals a daily issue in contemporary cardiology practice across the globe. In the balance lies the decision to employ long-term anticoagulation therapy with its attendant risk of severe bleeding. A variety of clinical risk scores are available to guide this decision, most prominently the CHA2DS2-VASc score, which cumulates the widely accepted, if unequally validated, clinical risk factors: heart failure (or impaired left ventricular function), hypertension, age, prior stroke (or transient ischemic attack or systemic thromboembolism), atherosclerotic vascular disease (as manifested by myocardial infarction, peripheral artery disease, or morphologically complex aortic atheroma), and female sex (1). Other scores recognize impaired renal function or other variables (2), and some emerging risk stratification approaches incorporate biomarkers, imaging of the morphology or flow properties of the left atrial appendage, and other considerations into the anticoagulation decision.
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research