Oral anticoagulation, aspirin, or no therapy in patients with nonvalvular AF with 0 or 1 stroke risk factor based on the CHA2DS2-VASc score

Journal of the American College of Cardiology
Gregory Y H LipTorben Bjerregaard Larsen

Abstract

Even a single additional stroke risk factor in patients with atrial fibrillation may confer a risk of stroke. However, there is no consensus on how best to treat these patients. Our objective was to investigate the risk of stroke and bleeding and the impact of antithrombotic therapy among low-risk patients, i.e., with 0 or 1 CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score risk factor. The nationwide cohort for this study was established by linking data from the Danish Civil Registration System, the Danish National Patient Register, and the Danish National Prescription Registry. We studied 39,400 patients discharged with incident nonvalvular atrial fibrillation with 0 or 1 CHA2DS2-VASc risk factor; 23,572 were not treated, 5,353 were initiated on aspirin, and 10,475 were initiated on warfarin. Stroke event rates for untreated low-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) were 0.49 per 100 person-years at 1 year and 0.47 per 100 person-years at full follow-up (intention-to-treat). Bleeding event rates among untreated low-risk patients were 1.08 per 100 person-years at 1 year and 0.97 at ful...Continue Reading

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Citations

Feb 20, 2016·Journal of the American College of Cardiology·Valentin Fuster
Feb 11, 2016·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Endalkachew A AlamnehLuke R Bereznicki
Jan 26, 2016·International Journal of Cardiology·Marco ProiettiGregory Y H Lip
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Jan 19, 2016·Revista Española De Cardiología·Rafael PeinadoJavier Chimeno
Nov 28, 2015·Journal of the American College of Cardiology·Gregory Y H Lip, Deirdre A Lane
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Sep 9, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gregory Y H LipMichael Field
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Sep 1, 2015·Stroke; a Journal of Cerebral Circulation·Gregory Y H LipPaul Dorian
Oct 20, 2018·Minerva medica·Maria Mahmood, Gregory Y Lip

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