Stroke Risk Stratification Schemes in Atrial Fibrillation in the Era of Non-Vitamin K Anticoagulants: Misleading and Obsolete, at least for the Low-Risk Patients?

Stroke Risk Stratification Schemes in Atrial Fibrillation in the Era of Non-Vitamin K Anticoagulants: Misleading and Obsolete, at least for the Low-Risk Patients?
Curr Drug Targets. 2016 Sep 5;
Authors: Manolis AS, Manolis TA, Manolis AA, Melita H
Abstract
The thromboembolic risk of atrial fibrillation (AF) is significantly mitigated by oral anticoagulation (OAC) therapy, albeit at an increasing bleeding risk. The general principle is that the expected protective benefit of OAC must not exceed the potential harm conferred by possible bleeding. Over the recent years, the CHA2DS2-VASc score has been proven to be superior to other scores in identifying 'low risk' AF patients. However, even this latest score does not incorporate all possible risk factors causing a high thromboembolic risk, while the individual components of the CHA2DS2-VASc score do not seem to carry equal thromboembolic risk. Thus, the quest for more reliable risk stratification schemes and identification of "truly low-risk" patients has been continued. A variety of clinical, echocardiographic, genetic and biochemical or coagulation parameters can also predict adverse thromboembolic events. Nevertheless, the addition or adoption of more complex schemes may defeat the purpose of simplicity and practicality, demanding more extensive and costly assessments to decide on a relatively simple question, that of the need for anticoagulation. In the era of non-vitamin K oral anti...

Source: Current Drug Targets - September 4, 2016 Category: Drugs & Pharmacology Authors: Manolis AS, Manolis TA, Manolis AA, Melita H Tags: Curr Drug Targets Source Type: research