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= Paid-up subscribersStratifying stroke risk in atrial fibrillation
20 Apr 2011
The CHA2DS2-VASc score appears to be better than the CHADS2 score at predicting patients with atrial fibrillation (AF) who will have a stroke over the next 10 years. It is also more accurate in identifying those at very low risk who do not need anticoagulation, a registry-based study has found. 'Estimating the risk of thrombo-embolism in AF is one of the most important aspects of the management of this common arrhythmia. To avoid a stroke at all costs using CHA2DS2-VASc thresholds for anticoagulation is preferable, but applying this at a population level may lead to an appreciable and significant increase in anticoagulant-related adverse events in patients who may still have a low risk of stroke. I think ultimately CHADS2 is the easiest to apply in everyday practice as a first-line tool with the more detailed scoring system applied to those scoring 1 with CHADS2 and who clinically appear to be at higher risk.'
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