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Refining Stroke Prediction in Atrial  Fibrillation Patients by Addition of African-American Ethnicity to CHA 2 DS 2 -VASc Score
Conclusions In patients> 65 years of age with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score  significantly improved stroke prediction.
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation
Conclusions: Patients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545)
Source: Journal of the American College of Cardiology - April 24, 2013 Category: Cardiology Authors: Oluseun Alli, Shepal Doshi, Saibal Kar, Vivek Reddy, Horst Sievert, Chris Mullin, Vijay Swarup, Brian Whisenant, David Holmes Tags: Heart Rhythm Disorders Source Type: research

Age Threshold for Increased Stroke Risk Among Patients With Atrial Fibrillation A Nationwide Cohort Study From Taiwan
This study hypothesized that the age threshold (65 years) used in the CHA2DS2-VASc system for initiating oral anticoagulants (OACs) might be lower in Taiwanese AF patients than in non-Asians.MethodsWe used the National Health Insurance Research Database in Taiwan to study 186,570 nonanticoagulated AF patients. There were 9,416 males with a CHA2DS2-VASc score of 0 and 6,390 females with a CHA2DS2-VASc score of 1. Their risk of ischemic stroke was analyzed with stratification on the basis of age.ResultsThe annual risks of ischemic stroke for males (score 0) and females (score 1) were 1.15% and 1.12%, respectively, and contin...
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research

Stroke Prediction in Atrial Fibrillation Is it Black and White? ∗
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 risk of ...
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research

Patients With Atrial Fibrillation and a CHA 2 DS 2 -VASc Score of 1 Are They at Low or High Stroke Risk? ∗
Nonvalvular atrial fibrillation carries a risk for developing ischemic stroke that is lowered by anticoagulant therapy (1). This risk is not uniform and depends on whether a patient has either none or ≥1 of the following factors, known as the CHA2DS2-VASc stroke risk score: congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category. Both European (2) and U.S. (3) guidelines advocate estimation of a patient’s stroke risk by use of the CHA2DS2-VASc score for initial risk stratification. The European Society of Cardiol...
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation: The Loire Valley Atrial Fibrillation Project
Conclusions: Renal impairment was not an independent predictor of IS/TE in patients with AF and did not significantly improve the predictive ability of the CHADS2 or CHA2DS2-VASc scores.
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Amitava Banerjee, Laurent Fauchier, Patrick Vourc'h, Christian R. Andres, Sophie Taillandier, Jean Michel Halimi, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Reply Comparing the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Scores for Stroke Prediction in Atrial Fibrillation
We tested the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke), and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) stroke risk scores in the CPRD (Clinical Practice Research Datalink) cohort of incident atrial fibrillation (AF) patients not using oral anticoagulants (OAC) because these are the patients for whom physicians must make the OAC treatment decision (1). The mean patient follo...
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research

The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)
Objectives: The goal of this study was to analyze the impact of dabigatran plasma concentrations, patient demographics, and aspirin (ASA) use on frequencies of ischemic strokes/systemic emboli and major bleeds in atrial fibrillation patients.Background: The efficacy and safety of dabigatran etexilate were demonstrated in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, but a therapeutic concentration range has not been defined.Methods: In a pre-specified analysis of RE-LY, plasma concentrations of dabigatran were determined in patients treated with dabigatran etexilate 110 mg twice daily (bid) ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: Paul A. Reilly, Thorsten Lehr, Sebastian Haertter, Stuart J. Connolly, Salim Yusuf, John W. Eikelboom, Michael D. Ezekowitz, Gerhard Nehmiz, Susan Wang, Lars Wallentin, RE-LY Investigators Tags: Antithrombotic Therapy Source Type: research

Effect of Diabetes and Glycemic Control on Ischemic Stroke Risk in AF Patients ATRIA Study
BackgroundDiagnosed diabetes mellitus (DM) is a consistently documented risk factor for ischemic stroke in patients with atrial fibrillation (AF).ObjectivesThe purpose of this study was to assess the association between duration of diabetes and elevated hemoglobin A1c (HbA1c) with risk of stroke among diabetic patients with AF.MethodsWe assessed this association in the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) California community-based cohort of AF patients (study years 1996 to 2003) where all events were clinician adjudicated. We used Cox proportional hazards regression to estimate the rate of isc...
Source: Journal of the American College of Cardiology - January 19, 2016 Category: Cardiology Source Type: research

Predicting Stroke in Patients With Atrial Fibrillation An Incomplete Picture Without Considering Quality of Anticoagulation
Van den Ham et al. (1) nicely compare the new stroke risk stratification tool anticoagulation and risk factors in atrial fibrillation (ATRIA) with CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Prior stroke, TIA, or thromboembolism, Vascular disease, Age 65–74 years, Sex category [female]) in patients with atrial fibrillation.
Source: Journal of the American College of Cardiology - May 3, 2016 Category: Cardiology Source Type: research

Comparing the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Scores for Stroke Prediction in Atrial Fibrillation
Van den Ham et al. (1) recently compared the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack), and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) stroke risk scores in a primary care community cohort of patients with first-diagnosed atrial fibrillation (AF) not using oral anticoagulation (OAC) for undefined reasons. They concluded that improved risk ...
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research

Should Atrial Fibrillation Patients With 1 Additional Risk Factor of the CHA 2 DS 2 -VASc Score (Beyond Sex) Receive Oral Anticoagulation?
ConclusionsNot all risk factors in CHA2DS2-VASc score carry an equal risk, with age 65 to 74 years associated with the highest stroke rate. Oral anticoagulation should be considered for AF patients with 1 additional stroke risk factor given their high risk of ischemic stroke.
Source: Journal of the American College of Cardiology - February 16, 2015 Category: Cardiology Source Type: research

Net Clinical Benefit of Antithrombotic Therapy in Patients With Atrial Fibrillation and Chronic Kidney Disease A Nationwide Observational Cohort Study
ConclusionsCKD is associated with a higher risk of stroke/thromboembolism across stroke risk strata in AF patients. High-risk CKD patients (CHA2DS2-VASc ≥2) with AF benefit from warfarin treatment for stroke prevention.
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research

Excessive Atrial Ectopy and Short Atrial Runs Increase the Risk of Stroke Beyond Incident Atrial Fibrillation
ConclusionsESVEA was associated with an increased risk of ischemic stroke beyond manifest AF in this middle-aged and older population. Stroke was more often the first clinical presentation, rather than AF, in these study subjects.
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research

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