Adding Rigor to Stroke Risk Prediction in Atrial Fibrillation ∗

Guidelines recommend oral anticoagulant (OAC) therapy for patients with atrial fibrillation (AF) on the basis of ischemic stroke risk. Guidelines from both the United States (American College of Cardiology/American Heart Association/Heart Rhythm Society [AHA/ACC/HRS]) (1) and from Europe (European Society of Cardiology [ESC]) (2) use the CHA2DS2-VASc risk score (3) and recommend a low threshold for OAC use. The ESC guideline proposes anticoagulation therapy for patients with ≥1 risk factor (≥1 point), whereas the AHA/ACC/HRS guideline uses a threshold of 2 points. Because ESC does not consider female sex as a stand-alone risk factor, the difference between the recommendations diminishes. In effect, the ESC guideline recommends anticoagulation therapy for ∼90% of patients with AF and the AHA/ACC/HRS guideline for ∼85% (4).
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research