Is female sex a risk modifier rather than a risk factor for stroke in patients with atrial fibrillation?
Initial decisions on oral anticoagulation in atrial fibrillation could be guided by the CHA2DS2-VA score, treating female sex as a risk modifier rather than a primary risk factor.
Female sex is a risk modifier for stroke in patients with atrial fibrillation. Initial decisions on oral anticoagulant treatment could be guided by a CHA2DS2-VA score (ie, excluding the sex category criterion), but the Sc risk component modifies and accentuates stroke risk in women who would have been eligible for oral anticoagulant treatment on the basis of ≥2 additional stroke risk factors.
Nielsen et al. (2018) studied this question.