Faculty Opinions recommendation of Comparison of risk stratification schemes to predict thromboembolism in people with nonvalvular atrial fibrillation.

Publisher Website
Google Scholar
Abstract
This study re-emphasises that the current stroke risk-stratification schemes in atrial fibrillation (AF) have only limited (and broadly comparable) overall predictive ability. Indeed, how a patient is treated can vary depending on which scheme is used. The authors assessed five stroke risk stratification schemes for their ability to predict AF–related thromboembolism in a large (n=13,559 adults with AF) community-based cohort, the ATRIA study. In this study, the proportion categorized as 'low risk' ranged from 11.7% to 37.1% across schemes, and the proportion considered 'high risk' ranged from 16.4% to 80.4%. Clearly, this shows wide variability in the ability of the different schemes to categorise AF patients. Of the various risk schemes, the CHADS2 categorised the most (61.2%) into the moderate risk category, which can cause some uncertainties for clinicians, since guidelines recommend warfarin or aspirin for 'moderate risk' patients. New ways to refine stroke risk stratification in AF is crucially needed, whether by using improved echocardiography or biomarker therapy (Lip et al., Stroke 2006, 37:2294-2300 [PMID:16888271]).

This publication has 0 references indexed in Scilit: