Key result
Cerebral amyloid angiopathy is a potent competing risk in cerebrovascular disease management, contributing to the underprescription of oral anticoagulants for atrial fibrillation.
Highlights the clinical challenge of balancing stroke prevention with bleeding risks, particularly concerning cerebral amyloid angiopathy in patients with atrial fibrillation.
reventative medications are routinely underprescribed in patients with clear indications, and undertreatment accounts for a substantial proportion of incident strokes. 1 This is especially true of atrial fibrillation where, even with direct oral anticoagulants that simplify therapy and improve adherence, initiation rates for oral anticoagulation within 12 months of new atrial fibrillation diagnosis remain a dismal 33%. 2 A major contributor to anticoagulation undertreatment is physicians overestimating bleeding risks while underestimating stroke risk.3,4 Cerebrovascular disease management requires clinicians to correctly estimate and weigh competing risks, and cerebral amyloid angiopathy (CAA) is among the most potent competing risks stroke specialists encounter.
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Matthew B. Maas (2023) conducted an editorial in Cerebral amyloid angiopathy and atrial fibrillation. Cerebral amyloid angiopathy is a potent competing risk in cerebrovascular disease management, contributing to the underprescription of oral anticoagulants for atrial fibrillation.
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