Key result
Oral anticoagulation for single-risk-factor AF requires individualized assessment of thromboembolic versus bleeding risks.
Why the study?
Oral anticoagulation in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1 (2 in women) remains challenging because therapeutic decisions must balance thromboembolic risk reduction against increased bleeding risk.
Does oral anticoagulation improve net clinical benefit in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1?
Does oral anticoagulation improve net clinical benefit in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1?
A personalized approach to assessing stroke versus bleeding risk is crucial for optimal decision-making regarding oral anticoagulation in intermediate-risk atrial fibrillation.
Supports personalized thromboembolic versus bleeding risk refinement before oral anticoagulation in CHA2DS2-VASc score 1 AF; leaves open net benefit confirmation by prospective trials.
Oral anticoagulation in patients presenting with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1 (CHA2DS2-VASc of 2 in women) remains a challenging approach in clinical practice. Therapeutic decisions need to balance the individual benefit of reducing thromboembolic risk against the potential harm due to an increase in bleeding risk in this intermediate risk patient population. Within the current opinion statement of the European Society of Cardiology working group of cardiovascular pharmacotherapy and the European Society of Cardiology council on stroke the currently available evidence on the anti-thrombotic management in patients presenting with a CHA2DS2-VASc of 1 is summarized. Easily applicable tools for a personalized refinement of the individual thromboembolic risk in patients with atrial fibrillation and a CHA2DS2-VASc score of 1 that guide clinicians through the question whether to anticoagulate or not are provided.
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Sulzgruber et al. (2019) conducted a review in Non-valvular atrial fibrillation. Oral anticoagulation vs. No oral anticoagulation was evaluated. Oral anticoagulation in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1 requires a personalized refinement of thromboembolic versus bleeding risks to assess net clinical benefit.
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