Wide Variation in Reported Rates of Stroke Across Cohorts of Patients with Atrial Fibrillation

Circulation

Volumn 135, Issue 3, 2017, Pages 208-219

  Quinn, Gene R ^a,c   Severdija, Olivia N ^b,c   Chang, Yuchiao ^c,d   Singer, Daniel E ^c,d  

^a Department of Internal Medicine Division of Cardiology   (China)

^b BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

anticoagulation; atrial fibrillation; bleeding risk; CHA2DS2 VASc; warfarin

Indexed keywords

ANTICOAGULANT AGENT;

ANTICOAGULANT THERAPY; ATRIAL FIBRILLATION; BRAIN ISCHEMIA; CARDIAC PATIENT; CHADS2 SCORE; HUMAN; MEDLINE; MORBIDITY; PRACTICE GUIDELINE; PRIORITY JOURNAL; QUESTIONNAIRE; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SCORING SYSTEM; SYSTEMATIC REVIEW; AGED; COHORT ANALYSIS; COMPLICATION; FEMALE; MALE; RISK FACTOR; STROKE;

AGED; ANTICOAGULANTS; ATRIAL FIBRILLATION; COHORT STUDIES; FEMALE; HUMANS; MALE; RISK FACTORS; STROKE;

EID: 85009833680     PISSN: 00097322     EISSN: 15244539     Source Type: Journal    
DOI: 10.1161/CIRCULATIONAHA.116.024057     Document Type: Review

References (51)

1. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med. 1994;154:1449-1457.
2. Singer DE, Chang Y, Fang MC, Borowsky LH, Pomernacki NK, Udaltsova N, Go AS. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2009;151:297-305.
3. Eckman MH, Singer DE, Rosand J, Greenberg SM. Moving the tipping point: the decision to anticoagulate patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2011;4:14-21. doi: 10.1161/CIRCOUTCOMES.110.958108.
4. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014;130:e199-e267. doi: 10.1161/CIR.0000000000000041.
5. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P; ESC Committee for Practice Guidelines-CPG; Document Reviewers. 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. Europace. 2012;14:1385-1413. doi: 10.1093/europace/eus305.
6. Olesen JB, Lip GY, Hansen ML, Hansen PR, Tolstrup JS, Lindhardsen J, Selmer C, Ahlehoff O, Olsen AM, Gislason GH, Torp-Pedersen C. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011;342:d124.
7. Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864-2870.
8. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263-272. doi: 10.1378/chest.09-1584.
9. Casciano JP, Singer DE, Kwong WJ, Fox ES, Martin BC. Anticoagulation therapy for patients with non-valvular atrial fibrillation: comparison of decision analytic model recommendations and real-world warfarin prescription use. Am J Cardiovasc Drugs. 2012;12:313-323. doi: 10.2165/11634150-000000000-00000.
10. Shah SV, Gage BF. Cost-effectiveness of dabigatran for stroke prophylaxis in atrial fibrillation. Circulation. 2011;123:2562-2570. doi: 10.1161/CIRCULATIONAHA.110.985655.
11. Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri. ca/programs/clinical-epidemiology/oxford.htm. Accessed July 22, 2016.
12. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-560. doi: 10.1136/bmj.327.7414.557.
13. Rothman KJ, Greenland S, Lash T. Modern Epidemiology. Philadelphia, PA: Lippincott, Williams & Wilkins; 2005.
14. Chao TF, Liu CJ, Tuan TC, Chen SJ, Wang KL, Lin YJ, Chang SL, Lo LW, Hu YF, Chen TJ, Chiang CE, Chen SA. Comparisons of CHADS2 and CHA2DS2-VASc scores for stroke risk stratification in atrial fibrillation: which scoring system should be used for Asians? Heart Rhythm. 2016;13:46-53. doi: 10.1016/j. hrthm.2015.08.017.
15. Lin LY, Lee CH, Yu CC, Tsai CT, Lai LP, Hwang JJ, Chen PC, Lin JL. Risk factors and incidence of ischemic stroke in Taiwanese with nonvalvular atrial fibrillation-a nation wide database analysis. Atherosclerosis. 2011;217:292-295. doi: 10.1016/j.atherosclerosis. 2011.03.033.
16. Wang TJ, Massaro JM, Levy D, Vasan RS, Wolf PA, D'Agostino RB, Larson MG, Kannel WB, Benjamin EJ. A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA. 2003;290:1049-1056. doi: 10.1001/jama.290.8.1049.
17. Abraham M, Larson J, Chung M, Curtis A, Lakshminarayan K, Newman J, Perez M, Rexrode K. Does CHA2 DS2-VASc improve stroke risk stratification in postmenopausal women with atrial fibrillation? Am J Med. 2013;18:1199-1216.
18. Fang MC, Go AS, Chang Y, Borowsky L, Pomernacki NK, Singer DE; ATRIA Study Group. Comparison of risk stratification schemes to predict thromboembolism in people with nonvalvular atrial fibrillation. J Am Coll Cardiol. 2008;51:810-815. doi: 10.1016/j. jacc.2007.09.065.
19. Banerjee A, Taillandier S, Olesen JB, Lane DA, Lallemand B, Lip GY, Fauchier L. Pattern of atrial fibrillation and risk of outcomes: the Loire Valley Atrial Fibrillation Project. Int J Cardiol. 2013;167:2682-2687. doi: 10.1016/j.ijcard.2012.06.118.
20. Forslund T, Wettermark B, Wändell P, von Euler M, Hasselström J, Hjemdahl P. Risks for stroke and bleeding with warfarin or aspirin treatment in patients with atrial fibrillation at different CHA(2)DS(2) VASc scores: experience from the Stockholm region. Eur J Clin Pharmacol. 2014;70:1477-1485. doi: 10.1007/s00228-014-1739-1.
21. Boulanger L, Hauch O, Friedman M, Foster T, Dixon D, Wygant G, Menzin J. Warfarin exposure and the risk of thromboembolic and major bleeding events among medicaid patients with atrial fibrillation. Ann Pharmacother. 2006;40:1024-1029. doi: 10.1345/aph.1G408.
22. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J. 2012;33:1500-1510. doi: 10.1093/eurheartj/ehr488.
23. Singer DE, Chang Y, Borowsky LH, Fang MC, Pomernacki NK, Udaltsova N, Reynolds K, Go AS. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. J Am Heart Assoc. 2013;2:e000250. doi: 10.1161/JAHA.113.000250.
24. Abu-Assi E, Otero-Raviña F, Allut Vidal G, Coutado Méndez A, Vaamonde Mosquera L, Sánchez Loureiro M, Caneda Villar MC, Fernández Villaverde JM, Maestro Saavedra FJ, González-Juanatey JR; Grupo Barbanza researchers. Comparison of the reliability and validity of four contemporary risk stratification schemes to predict thromboembolism in non-anticoagulated patients with atrial fibrillation. Int J Cardiol. 2013;166:205-209. doi: 10.1016/j. ijcard.2011.10.096.
25. Guo Y, Apostolakis S, Blann AD, Wang H, Zhao X, Zhang Y, Zhang D, Ma J, Wang Y, Lip GY. Validation of contemporary stroke and bleeding risk stratification scores in non-anticoagulated Chinese patients with atrial fibrillation. Int J Cardiol. 2013;168:904-909. doi: 10.1016/j.ijcard.2012.10.052.
26. Guo Y, Wang H, Tian Y, Wang Y, Lip GY. Time trends of aspirin and warfarin use on stroke and bleeding Eevents in Chinese patients with new-onset atrial fibrillation. Chest. 2015;148:62-72. doi: 10.1378/chest.14-2018.
27. Apostolakis S, Zubaid M, Rashed WA, Alsheikh-Ali AA, Almahmeed W, Shehab A, Sulaiman K, Alqudaimi A, Asaad N, Amin H, Lane DA, Lip GY; Gulf Survey of Atrial Fibrillation Events investigators. Assessment of stroke risk in Middle Eastern patients with atrial fibrillation: the Gulf SAFE registry. Int J Cardiol. 2013;168:1644-1646. doi: 10.1016/j.ijcard.2013.02.003.
28. van den Ham HA, Klungel OH, Singer DE, Leufkens HG, van Staa TP. Comparative performance of ATRIA, CHADS2, and CHA2DS2-VASc risk scores predicting stroke in patients with atrial fibrillation: results from a national primary care database. J Am Coll Cardiol. 2015;66:1851-1859. doi: 10.1016/j.jacc.2015.08.033.
29. Inoue H, Atarashi H; Research Group for Antiarrhythmic Drug Therapy. Risk factors for thromboembolism in patients with paroxysmal atrial fibrillation. Am J Cardiol. 2000;86:852-855.
30. Komatsu T, Sato Y, Ozawa M, Kunugita F, Yoshizawa R, Morino Y, Nakamura M. Comparison between CHADS2 and CHA2DS2-VASc score for risk stratification of ischemic stroke in Japanese patients with non-valvular paroxysmal atrial fibrillation not receiving anticoagulant therapy. Int Heart J. 2014;55:119-125.
31. Larsen TB, Lip GY, Skjøth F, Due KM, Overvad K, Hvilsted Rasmussen L. Added predictive ability of the CHA2DS2VASc risk score for stroke and death in patients with atrial fibrillation: the prospective Danish Diet, Cancer, and Health cohort study. Circ Cardiovasc Qual Outcomes. 2012;5:335-342. doi: 10.1161/CIRCOUTCOMES.111.964023.
32. Suzuki S, Yamashita T, Okumura K, Atarashi H, Akao M, Ogawa H, Inoue H. Incidence of ischemic stroke in Japanese patients with atrial fibrillation not receiving anticoagulation therapy-pooled analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry. Circ J. 2015;79:432-438. doi: 10.1253/circj. CJ-14-1131.
33. Parkash R, Wee V, Gardner MJ, Cox JL, Thompson K, Brownell B, Anderson DR. The impact of warfarin use on clinical outcomes in atrial fibrillation: a population-based study. Can J Cardiol. 2007;23:457-461.
34. Saliba W, Barnett-Griness O, Elias M, Rennert G. Glycated hemoglobin and risk of first episode stroke in diabetic patients with atrial fibrillation: a cohort study. Heart Rhythm. 2015;12:886-892. doi: 10.1016/j.hrthm.2015.01.025.
35. Siu CW, Lip GY, Lam KF, Tse HF. Risk of stroke and intracranial hemorrhage in 9727 Chinese with atrial fibrillation in Hong Kong. Heart Rhythm. 2014;11:1401-1408. doi: 10.1016/j. hrthm.2014.04.021.
36. Olesen JB, Lip GY, Lindhardsen J, Lane DA, Ahlehoff O, Hansen ML, Raunsø J, Tolstrup JS, Hansen PR, Gislason GH, Torp-Pedersen C. 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. doi: 10.1160/TH11-05-0364.
37. Singer DE, Hughes RA, Gress DR, Sheehan MA, Oertel LB, Maraventano SW, Blewett DR, Rosner B, Kistler JP. The effect of aspirin on the risk of stroke in patients with nonrheumatic atrial fibrillation: the BAATAF study. Am Heart J. 1992;124:1567-1573.
38. The ACTIVE Writing Group. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367:1903-1912.
39. Hobbs FD, Roalfe AK, Lip GY, Fletcher K, Fitzmaurice DA, Mant J; Birmingham Atrial Fibrillation in the Aged Investigators and Midland Research Practices Consortium Network. Performance of stroke risk scores in older people with atrial fibrillation not taking warfarin: comparative cohort study from BAFTA trial. BMJ. 2011;342:d3653.
40. Edvardsson N, Juul-Möller S, Omblus R, Pehrsson K. Effects of low-dose warfarin and aspirin versus no treatment on stroke in a medium-risk patient population with atrial fibrillation. J Intern Med. 2003;254:95-101.
41. Connolly SJ, Laupacis A, Gent M, Roberts RS, Cairns JA, Joyner C. Canadian Atrial Fibrillation Anticoagulation (CAFA) study. J Am Coll Cardiol. 1991;18:349-355.
42. Ezekowitz MD, Bridgers SL, James KE, Carliner NH, Colling CL, Gornick CC, Krause-Steinrauf H, Kurtzke JF, Nazarian SM, Radford MJ; Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation investigators. Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. N Engl J Med. 1992;327:1406-1412. doi: 10.1056/NEJM199211123272002.
43. Gage BF, van Walraven C, Pearce L, Hart RG, Koudstaal PJ, Boode BS, Petersen P. Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004;110:2287-2292. doi: 10.1161/01. CIR.0000145172.55640.93.
44. Okumura K, Inoue H, Atarashi H, Yamashita T, Tomita H, Origasa H; J-RHYTHM Registry investigators. Validation of CHA?DS?-VASc and HAS-BLED scores in Japanese patients with nonvalvular atrial fibrillation: an analysis of the J-RHYTHM Registry. Circ J. 2014;78:1593-1599.
45. Coppens M, Eikelboom JW, Hart RG, Yusuf S, Lip GY, Dorian P, Shestakovska O, Connolly SJ. The CHA2DS2-VASc score identifies those patients with atrial fibrillation and a CHADS2 score of 1 who are unlikely to benefit from oral anticoagulant therapy. Eur Heart J. 2013;34:170-176. doi: 10.1093/eurheartj/ehs314.
46. Sandhu RK, Bakal JA, Ezekowitz JA, McAlister FA. Risk stratification schemes, anticoagulation use and outcomes: the risk-treatment paradox in patients with newly diagnosed non-valvular atrial fibrillation. Heart. 2011;97:2046-2050. doi: 10.1136/heartjnl-2011-300901.
47. Eckman MH, Wise RE, Speer B, Sullivan M, Walker N, Lip GY, Kissela B, Flaherty ML, Kleindorfer D, Khan F, Kues J, Baker P, Ireton R, Hoskins D, Harnett BM, Aguilar C, Leonard A, Prakash R, Arduser L, Costea A. Integrating real-time clinical information to provide estimates of net clinical benefit of antithrombotic therapy for patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2014;7:680-686. doi: 10.1161/CIRCOUTCOMES.114.001163.
48. 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. doi: 10.1016/j. jacc.2014.10.052.
49. Koton S, Schneider AL, Rosamond WD, Shahar E, Sang Y, Gottesman RF, Coresh J. Stroke incidence and mortality trends in US communities, 1987 to 2011. JAMA. 2014;312:259-268. doi: 10.1001/jama.2014.7692.
50. Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S, Flaker G, Avezum A, Hohnloser SH, Diaz R, Talajic M, Zhu J, Pais P, Budaj A, Parkhomenko A, Jansky P, Commerford P, Tan RS, Sim KH, Lewis BS, Van Mieghem W, Lip GY, Kim JH, Lanas-Zanetti F, Gonzalez-Hermosillo A, Dans AL, Munawar M, O'Donnell M, Lawrence J, Lewis G, Afzal R, Yusuf S; AVERROES Steering Committee and investigators. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364:806-817. doi: 10.1056/NEJMoa1007432.
51. Lip GY. The role of aspirin for stroke prevention in atrial fibrillation. Nat Rev Cardiol. 2011;8:602-606. doi: 10.1038/nrcardio. 2011.112.