Anticoagulation therapy and the risk of stroke in patients with atrial fibrillation at 'moderate risk' [CHADS2 score=1]: Simplifying stroke risk assessment and thromboprophylaxis in real-life clinical practice

Thrombosis and Haemostasis

Volumn 103, Issue 4, 2010, Pages 683-685

  Lip, Gregory Y H ^a  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; ANTIVITAMIN K; CLOPIDOGREL; DABIGATRAN;

ANTICOAGULANT THERAPY; CEREBROVASCULAR ACCIDENT; CLINICAL PRACTICE; EDITORIAL; HEART ATRIUM FIBRILLATION; HUMAN; PRIORITY JOURNAL; RISK ASSESSMENT; STROKE; THROMBOEMBOLISM;

ADMINISTRATION, ORAL; AGE FACTORS; ANTICOAGULANTS; ATRIAL FIBRILLATION; DIABETES COMPLICATIONS; DISEASE-FREE SURVIVAL; DRUG PRESCRIPTIONS; DRUG THERAPY, COMBINATION; FIBRINOLYTIC AGENTS; HEALTH STATUS INDICATORS; HEART FAILURE; HUMANS; INCIDENCE; PLATELET AGGREGATION INHIBITORS; PRACTICE GUIDELINES AS TOPIC; RISK ASSESSMENT; RISK FACTORS; STROKE; TIME FACTORS; TREATMENT OUTCOME;

EID: 77952063300     PISSN: 03406245     EISSN: None     Source Type: Journal    
DOI: 10.1160/TH10-01-0038     Document Type: Editorial

References (24)

1. Hughes M, Lip GY, Guideline Development Group. National Clinical Guideline for Management of Atrial Fibrillation in Primary and Secondary Care, National Institute for Health and Clinical Excellence. Stroke and thromboembolism in atrial fibril- lation: a systematic review of stroke risk factors, risk stratification schema and cost effectiveness data. Thromb Haemost 2008; 99: 295-304.
2. McBane RD, Hodge DO, Wysokinski WE. Clinical and echocardiographic measures governing thromboembolism destination in atrial fibrillation. Thromb Haemost 2008; 99: 951-955. (Pubitemid 351705314)
3. Lip GY, Lim HS. Atrial fibrillation and stroke prevention. Lancet Neurol 2007; 6: 981-993.
4. Connolly SJ, Eikelboom J, O'Donnell M, et al. Challenges of establishing new antithrombotic therapies in atrial fibrillation. Circulation 2007; 116: 449-455. (Pubitemid 47196550)
5. Fang MC, Go AS, Chang Y, et al. Comparison of risk stratification schemes to predict thromboembolism in people with nonvalvular atrial fibrillation. J Am Coll Cardiol 2008; 51: 810-815. (Pubitemid 351253746)
6. Poli D, Antonucci E, Grifoni E, et al. Stroke risk in atrial fibrillation patients on warfarin. Predictive ability of risk stratification schemes for primary and secondary prevention. Thromb Haemost 2009; 101: 367-372.
7. Lip GY, Zarifis J, Watson RD, et al. Physician variation in the management of patients with atrial fibrillation. Heart 1996; 75: 200-205. (Pubitemid 26068699)
8. Nieuwlaat R, Capucci A, Lip GY, et al. Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation. Eur Heart J 2006; 27: 3018-3026. (Pubitemid 44963431)
9. Wysokinski WE, Owen WG, Fass DN, et al. 2nd. Atrial fibrillation and thrombosis: immunohistochemical differences between in situ and embolized thrombi. J Thromb Haemost 2004; 2: 1637-1644.
10. Kamath S, Blann AD, Chin BS, et al. A prospective randomized trial of aspirin-clopidogrel combination therapy and dose-adjusted warfarin on indices of thrombogenesis and platelet activation in atrial fibrillation. J Am Coll Cardiol 2002; 40: 484-490. (Pubitemid 34833164)
11. Mant J, Hobbs FD, Fletcher K, et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged study, BAFTA): a randomized controlled trial. Lancet 2007; 370: 493-503. (Pubitemid 47212371)
12. Rash A, Downes T, Portner R, et al. A randomised controlled trial of warfarin versus aspirin for stroke prevention in octogenarians with atrial fibrillation (WASPO). Age Ageing 2007; 36: 151-156. (Pubitemid 46455393)
13. Sato H, Ishikawa K, Kitabatake A, et al. Low-dose aspirin for prevention of stroke in low-risk patients with atrial fibrillation: Japan Atrial Fibrillation Stroke Trial. Stroke 2006; 37: 447-451. (Pubitemid 43732003)
14. Healey JS, Hart RG, Pogue J, et al. Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: The Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE-W). Stroke 2008; 39: 1482-1486.
15. Lee BH, Park JS, Park JH, et al. The effect and safety of the anti-thrombotic therapies in patients with atrial fibrillation and CHADS2 score 1. J Cardiovasc Electrophysiol 2010; in press.
16. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-1151.
17. Gorin L, Fauchier L, Nonin et al. Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1. Thromb Haemost 2010; 103: 833-840.
18. Singer DE, Albers GW, Dalen JE, et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133: 546S-592S.
19. Apostolakis S, Shantsila E, Lip GY, et al. Contra: "Anti-platelet therapy is an alternative to oral anticoagulation for atrial fibrillation". Thromb Haemost 2009; 102: 914-915.
20. Healey JS. Pro: "Anti-platelet therapy is an alternative to oral anticoagulation for atrial fibrillation". Thromb Haemost 2009; 102: 912-913.
21. Lip GYH, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach. Chest 2009; prepublished online doi:10.1378/chest.09-1584.
22. Lip GYH, Halperin JL. Improving stroke risk stratification in atrial fibrillation. Am J Med 2010; in press.
23. Rietbrock S, Plumb JM, Gallagher AM, et al. How effective are dose-adjusted warfarin and aspirin for the prevention of stroke in patients with chronic atrial fibrillation? An analysis of the UK General Practice Research Database. Thromb Haemost 2009; 101: 527-534.
24. Tay KH, Lip GY, Lane DA. Atrial fibrillation and stroke risk prevention in real-life clinical practice. Thromb Haemost 2009; 101: 415-416.