In patients with atrial fibrillation receiving oral anticoagulation, previous stroke or transient ischemic attack was the strongest independent predictor of residual thromboembolic risk (HR 2.87).
Observational (n=18,955)
Yes
What factors are associated with residual risk for stroke, systemic embolism, or transient ischemic attack in patients with atrial fibrillation despite oral anticoagulation?
Despite oral anticoagulation, patients with atrial fibrillation remain at risk for thromboembolic events, particularly those with previous stroke/TIA, female sex, hypertension, and permanent AF.
Effect estimate: HR 2.87 (95% CI 2.30-3.59)
p-value: p=<0.001
Background: Oral anticoagulation (OAC) reduces the risk of thromboembolic events in patients with atrial fibrillation (AF); however, thromboembolism (TE) still can occur despite OAC. Factors associated with residual risk for stroke, systemic embolism, or transient ischemic attack events despite OAC have not been well described. Objective: The purpose of this study was to evaluate the residual risk of thromboembolic events in patients with AF despite OAC. Methods: A total of 18,955 patients were analyzed in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF I and II) using multivariable Cox proportional hazard modeling. Mean age was 72 ± 10.7, and 42% were women. There were 451 outcome events. Results: = .001). When transient ischemic attack was excluded, the results were similar, but permanent AF was no longer significantly associated with thromboembolic events. Conclusion: -VASc score despite OAC. Key risk markers include previous stroke/transient ischemic attack, female sex, hypertension, and permanent AF.
Carlisle et al. (2022) conducted an observational in Atrial fibrillation (n=18,955). Oral anticoagulation was evaluated on Thromboembolic events (stroke, systemic embolism, or transient ischemic attack) associated with previous stroke/TIA (HR 2.87, 95% CI 2.30-3.59, p=<0.001). In patients with atrial fibrillation receiving oral anticoagulation, previous stroke or transient ischemic attack was the strongest independent predictor of residual thromboembolic risk (HR 2.87).
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