Is an Oral Anticoagulant Necessary for Young Atrial Fibrillation Patients With a CHA2DS2-VASc Score of 1 (Men) or 2 (Women)? Arrhythmia and Electrophysiology

ConclusionsFor atrial fibrillation patients aged 20 to 49 years with 1 risk factor in addition to sex, non–vitamin K antagonist OACs should be considered for stroke prevention to minimize the risk of a potentially fatal or disabling event.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Atrial Fibrillation Original Research Source Type: research

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Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
AbstractAtrial fibrillation is the most common arrhythmia and its prevalence is expected to further increase. Patients with atrial fibrillation have an increased risk of stroke (fivefold increased risk), heart failure, and death. In patients with non-valvular atrial fibrillation, the most recent guidelines recommend the use of the CHA2DS2-VASc (congestive heart failure, arterial hypertension, age  >  75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65–74 years, sex category) scoring system to identify those who may benefit from oral anticoagulant treatmen...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Background and Purpose—The CHA2DS2-VASc stroke score (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65–74, female) is used in most guidelines for risk stratification in atrial fibrillation (AF), but most data for this score have been derived in Western populations. Ethnic differences in stroke risk may be present. Our objective was to investigate risk factors for stroke in AF and application of the CHA2DS2-VASc score in an Asian AF population from Korea.Methods—A total of 5855 oral anticoagulant&n...
Source: Stroke - Category: Neurology Authors: Tags: Arrhythmias, Risk Factors, Ischemic Stroke Original Contributions Source Type: research
Atrial fibrillation is the most common cardiac arrhythmia and conveys a significant risk of morbidity and mortality due to related stroke and systemic embolism. Oral anticoagulation (OAC) is the mainstay of thromboembolism prevention, and management of anticoagulation can be challenging. For patients without significant valvular disease, decisions around anticoagulation therapy are first based on the presence of additional stroke risk factors, as measured by the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75, diabetes, prior stroke or transient ischemic attack, vascular disease, age 65–74, and sex c...
Source: Blood - Category: Hematology Authors: Tags: How I Treat, Free Research Articles, Thrombosis and Hemostasis Source Type: research
Atrial fibrillation (AF) is a common arrhythmia that predisposes patients to risk of stroke (1) that can be prevented with anticoagulation (2) . However, a minority of patients with AF and risk of stroke are treated with anticoagulants (3) , with undertreatment being due to a variety of factors. Optimizing treatment depends, in part, on the ability to understand risks, benefits, and personal preferences of individual patients. The CHADS 2 (congestive heart failure, hypertension, age  ≥75 years, diabetes, and 2 points for prior stroke or transient ischemic attack) scoring system has been useful for stratifying ris...
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research
Abstract Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and...
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
Conclusions The risk of developing ischemic stroke was almost 11 times higher in young patients with CHD than in the general population, although absolute risk is low. Cardiovascular comorbidities were strongly associated with the development of ischemic stroke in young CHD patients.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Epidemiology, Congenital Heart Disease, Ischemic Stroke Source Type: research
Background In comparison to warfarin, non–vitamin K antagonist oral anticoagulants (NOACs) have the advantages of ease of dosing, fewer drug interactions, and lack of need for ongoing monitoring. We sought to evaluate whether these advantages translate to improved adherence and whether adherence is associated with improved outcomes in patients with atrial fibrillation. Methods and Results We performed a retrospective cohort analysis by using a large US commercial insurance database to identify 64 661 patients with atrial fibrillation who initiated warfarin, dabigatran, rivaroxaban, or apixaban treatment between...
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research
Background Atrial fibrillation (AF) is a common, growing, and costly medical condition. We aimed to evaluate the impact of a management algorithm for symptomatic AF that used an emergency department observation unit on hospital admission rates and patient outcomes. Methods and Results This retrospective cohort study compared 563 patients who presented consecutively in the year after implementation of the algorithm, from July 2013 through June 2014 (intervention group), with 627 patients in a historical cohort (preintervention group) who presented consecutively from July 2011 through June 2012. All patients who consented t...
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Arrhythmias, Atrial Fibrillation, Cost-Effectiveness, Quality and Outcomes Arrhythmia and Electrophysiology Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
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