What is the clinical evidence from this study?

Study design: Other. Population: Atrial fibrillation. Intervention: Warfarin.

What question did this study set out to answer?

To assess the agreement among three stroke risk stratification schemes and evaluate their predictive accuracy for adverse thrombotic and bleeding events in patients with atrial fibrillation.

January 1, 2009Thrombosis and Haemostasis

Stroke risk in atrial fibrillation patients on warfarin

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Key result

No clinical study data is present in the provided text, which consists only of journal editorial board information.

Why the study?

How do different risk stratification schemes (CHADS2, NICE, ACCP) compare in classifying stroke risk and predicting adverse events in atrial fibrillation patients on long-term oral anticoagulant therapy?

Population

662 atrial fibrillation (AF) patients on long-term oral anticoagulant therapy (OAT)

Design

Cohort

Authors

EAEmilia AntonucciANT Foundation Italy Onlus EGElisa GrifoniOspedale San Giuseppe RARosanna AbbateUniversity of Florence

Discussion

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Implication

Absence of study data precludes comparing CHADS2, NICE, and ACCP schemes in AF on OAT; leaves optimal stratification open.

Key Points

To assess the agreement among three stroke risk stratification schemes and evaluate their predictive accuracy for adverse thrombotic and bleeding events in patients with atrial fibrillation.
Conducted a prospective cohort study of 662 patients with atrial fibrillation receiving long-term oral anticoagulant therapy with warfarin.
Categorized patient risk using CHADS(2), NICE, and ACCP schemes and tracked major bleeding and thrombotic events during follow-up.
High-risk patient classification varied substantially among models: 46.1% for CHADS(2), 69.8% for NICE, and 95.3% for ACCP, with CHADS(2) and NICE providing the best predictive accuracy.
CHADS(2) misclassified 6.3% (14 of 222) of secondary prevention patients as moderate risk despite their verified high risk status.
During follow-up, 32 major bleeding events (1.35 per 100 patient-years) and 39 thrombotic events (1.64 per 100 patient-years) occurred, with both outcomes clustering predominantly in high-risk patients.

Structured PICO

Population

662 atrial fibrillation (AF) patients on long-term oral anticoagulant therapy (OAT)

Intervention

Risk stratification using CHADS2, NICE, and ACCP schemes

Outcome

Agreement among different risk stratification schemes and their correlation with adverse events (major bleeding and thrombotic events) during follow-uphard clinical

CHADS2 and NICE scores provide the best predictive accuracy for adverse events in AF patients on OAT, and patients requiring secondary prevention are inherently at high risk and should receive warfarin without further stratification.

Cite This Study

Antonucci et al. (2009) studied Atrial fibrillation. Warfarin was evaluated. No clinical study data is present in the provided text, which consists only of journal editorial board information.

synapsesocial.com/papers/6a0f0afb06ecbe833448186e https://doi.org/10.1160/th08-09-0592

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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Stroke risk in atrial fibrillation patients on warfarin

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Stroke risk in atrial fibrillation patients on warfarin

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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