Key result
Atrial fibrillation is associated with a fivefold increase in the risk of stroke, and the CHA2DS2-VASc scheme is recommended to accurately identify low-risk patients.
Effect estimate: fivefold increase
This review highlights the utility of the CHA2DS2-VASc score in accurately identifying low-risk atrial fibrillation patients who can safely avoid antithrombotic therapy.
May support CHA2DS2-VASc for low-risk AF identification; leaves open prospective validation before practice change.
Atrial fibrillation (AF) is a highly prevalent arrhythmia associated with a fivefold increase in the risk of stroke. However, this risk is not homogeneous and varies considerably depending on the presence of several demographic and clinical factors. Independent risk factors for stroke in patients with AF include age ≥65 years, female sex, congestive heart failure, prior stroke or transient ischemic attack, hypertension, diabetes mellitus and vascular disease. Based on these indicators, risk stratification schemes to identify patients at low-, moderate-, and high-risk for stroke have been developed and validated. The CHADS 2 and CHA 2 DS 2 -VASc schemes are widely used and have good predictive accuracy for stroke. Current guidelines recommend the CHA 2 DS 2 -VASc scheme, in part because it more accurately identifies patients at truly low risk for stroke who do not require antithrombotic therapy. This article provides an overview of risk factors for stroke in patients with AF, including discussion of the CHADS 2 and CHA 2 DS 2 -VASc schemes.
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Fohtung et al. (2016) conducted a review in Atrial fibrillation. Atrial fibrillation was evaluated on Stroke (fivefold increase). Atrial fibrillation is associated with a fivefold increase in the risk of stroke, and the CHA2DS2-VASc scheme is recommended to accurately identify low-risk patients.
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