Non-valvular atrial fibrillation patients with none or one additional risk factor of the CHA2DS2-VASc score: A comprehensive net clinical benefit analysis for warfarin, aspirin, or no therapy

Thrombosis and Haemostasis

Volumn 114, Issue 4, 2015, Pages 826-834

  Lip, Gregory Y H ^a,b   Skjøth, Flemming ^a,c   Nielsen, Peter B ^a,c   Larsen, Torben Bjerregaard ^a,c  

^a AALBORG UNIVERSITY   (Denmark)

^b UNIVERSITY OF BIRMINGHAM   (United Kingdom)

^c AALBORG UNIVERSITY HOSPITAL   (Denmark)

Author keywords

Bleeding; Mortality; Net clinical benefit; Stroke

Indexed keywords

ACETYLSALICYLIC ACID; WARFARIN; FIBRINOLYTIC AGENT;

ADULT; AGED; ANTICOAGULANT THERAPY; ARTICLE; ATRIAL FIBRILLATION; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CARDIOVASCULAR DISEASE ASSESSMENT; CARDIOVASCULAR MORTALITY; CHA2DS2 VASC SCORE; COMORBIDITY; DISEASE REGISTRY; FEMALE; FOLLOW UP; HEART INFARCTION; HOSPITAL DISCHARGE; HUMAN; LOW RISK PATIENT; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PERIPHERAL OCCLUSIVE ARTERY DISEASE; PRIORITY JOURNAL; RISK FACTOR; BLEEDING; CHEMICALLY INDUCED; COMPARATIVE STUDY; COMPLICATION; DECISION SUPPORT SYSTEM; DENMARK; MIDDLE AGED; MORTALITY; ORAL DRUG ADMINISTRATION; PATIENT SELECTION; PREDICTIVE VALUE; REGISTER; RISK ASSESSMENT; STROKE; TIME FACTOR; TREATMENT OUTCOME; VERY ELDERLY;

ADMINISTRATION, ORAL; AGED; AGED, 80 AND OVER; ASPIRIN; ATRIAL FIBRILLATION; DECISION SUPPORT TECHNIQUES; DENMARK; FEMALE; FIBRINOLYTIC AGENTS; HEMORRHAGE; HUMANS; MALE; MIDDLE AGED; PATIENT SELECTION; PREDICTIVE VALUE OF TESTS; REGISTRIES; RISK ASSESSMENT; RISK FACTORS; STROKE; TIME FACTORS; TREATMENT OUTCOME; WARFARIN;

EID: 84943138698     PISSN: 03406245     EISSN: None     Source Type: Journal    
DOI: 10.1160/TH15-07-0565     Document Type: Article

References (29)

1. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-867.
2. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: A meta-analysis of randomised trials. Lancet 2014; 383: 955-962.
3. Camm A, Lip G, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Hear J 2012; 33: 2719-2747.
4. National-Institute-for-Health-and-Care-Excellence. Atrial fibrillation: the management of atrial fibrillation. (Clinical guideline 180.) 2014. http: //guidance. nice.org.uk/CG180. 2014; http: //guidance.nice.org.uk/CG180. Available at: http://guidance.nice.org.uk/CG180.
5. Singer DE, Chang Y, Fang MC, et al. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med 2009; 151: 297-305.
6. Connolly SJ, Eikelboom JW, Ng J, et al. Net clinical benefit of adding clopidogrel to aspirin therapy in patients with atrial fibrillation for whom vitamin K antagonists are unsuitable. Ann Intern Med 2011; 155: 579-586.
7. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the 2014; 64: e1-e76.
8. Friberg L, Skeppholm M, Terént A. Benefit of Anticoagulation Unlikely in Patients With Atrial Fibrillation and a CHA2DS2-VASc Score of 1. J Am Coll Cardiol 2015; 65: 225-232.
9. Chao T-F, Liu C-J, Wang K-L, et al. Should Atrial Fibrillation Patients With 1 Additional Risk Factor of the CHA2DS2-VASc Score (Beyond Sex) Receive Oral Anticoagulation? J Am Coll Cardiol 2015; 65: 635-642.
10. Lip GYH, Skjøth F, Rasmussen LH, et al. Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA2DS2-VASc Score. J Am Coll Cardiol 2015 Epub ahead of print.
11. Nielsen PB, Chao T. The risks of risk scores for stroke risk assessment in atrial fibrillation. Thromb Haemost 2015; 113: 1170-1173.
12. Olesen JB, Torp-Pedersen C. Stroke risk in atrial fibrillation: Do we anticoagulate CHADS2 or CHA2DS2-VASc _ 1, or higher? Thromb Haemost 2015; 113: 1165-1169.
13. Lip GYH, Skjøth F, Rasmussen LH, et al. Net Clinical Benefit for Oral Anticoagulation, Aspirin, or No Therapy in Nonvalvular Atrial Fibrillation Patients With One Additional Risk Factor of the CHA2DS2-VASc Score (Beyond Sex). J Am Coll Cardiol 2015; Epub ahead of print.
14. Ray W. Evaluating medication effects outside of clinical trials: new-user designs. Am J Epidemiol 2003; 158: 915-920.
15. Olesen JB, Lip GYH, Lindhardsen J, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thromb Haemost 2011; 106: 739-749.
16. Friberg L, Rosenqvist M, Lip GYH. Net clinical benefit of warfarin in patients with atrial fibrillation: a report from the Swedish atrial fibrillation cohort study. Circulation 2012; 125: 2298-2307.
17. Nielsen PB, Skjøth F, Rasmussen LH, et al. Using the CHA2DS2-VASc score for stroke prevention in atrial fibrillation: A focus on vascular disease, females and simple practical application. Can J Cardiol 2015; Epub ahead of print.
18. Friberg L, Rosenqvist M. Cardiovascular hospitalisation as a surrogate endpoint for mortality in studies of atrial fibrillation: Report from the Stockholm Cohort Study of Atrial Fibrillation. Europace 2011; 13: 626-633.
19. Banerjee A, Lane DA, Torp-Pedersen C, et al. Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus no treatment in a ‘real world’ atrial fibrillation population: a modelling analysis based on a nationwide cohort study. Thromb Haemost 2012; 107: 584-589.
20. Skjøth F, Larsen TB, Rasmussen LH, et al. Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis. Thromb Haemost 2014; 111: 1-8.
21. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2013; 369: 2093-2104.
22. Eckman MH, Singer DE, Rosand J, et al. Moving the tipping point: the decision to anticoagulate patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes 2011; 4: 14-21.
23. Lip GYH, Clemens A, Noack H, et al. Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database. Thromb Haemost 2014; 111: 933-942.
24. De Caterina R, Husted S, Wallentin L, et al. Vitamin K antagonists in heart disease: Current status and perspectives (Section III). Position Paper of the ESC Working Group on Thrombosis-Task Force on Anticoagulants in Heart Disease. Thromb Haemost 2013; 110: 1087-1107.
25. Lane DA, Lip GYH. Patient’s values and preferences for stroke prevention in atrial fibrillation: balancing stroke and bleeding risk with oral anticoagulation. Thromb. Haemost 2014; 111: 381-383.
26. Lahaye S, Regpala S, Lacombe S, et al. Evaluation of patients’ attitudes towards stroke prevention and bleeding risk in atrial fibrillation. Thromb Haemost 2013; 111.
27. Friberg L, Rosenqvist M, Lip GYH. Net clinical benefit of warfarin in patients with atrial fibrillation: A report from the swedish atrial fibrillation cohort study. Circulation 2012; 125: 2298-2307.
28. Olesen JB, Lip GYH, Lindhardsen J, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thromb Haemost 2011; 106: 739-749.
29. Rix TA, Riahi S, Overvad K, et al. Validity of the diagnoses atrial fibrillation and atrial flutter in a Danish patient registry. Scand Cardiovasc J 2012; 46: 149-153.