Study Compares Anticoagulation Risk Scores in Atrial Fibrillation

H.A. (Hendrika) van den Ham PharmD Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences Utrecht University The Netherlands. MedicalResearch.com Interview with:
H.A. (Hendrika) van den Ham PharmD

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences
Utrecht University
The Netherlands.

Medical Research: What is the background for this study? What are the main findings?

Dr. van den Ham: Atrial fibrillation (AF) is associated with a substantial risk of ischemic stroke and thromboembolism. The CHADS2 and the CHA2DS2-VASc risk scores are developed to guide the decision to prescribe anticoagulants. Recently a new clinically-based risk score, the ATRIA study risk score, was developed. We compared the predictive ability of the ATRIA risk score with the CHADS2 and CHA2DS2-VASc risk scores in a large, independent, community-based cohort of Atrial fibrillation patients in the United Kingdom. We found that the ATRIA score more accurately identified low risk patients that the CHA2DS2-VASc score assigned to higher risk categories. Such reclassification of stroke risk could prevent overuse of anticoagulants in very low stroke risk patients with Atrial fibrillation.

Medical Research: What should clinicians and patients take away from your report?

Dr. van den Ham: Current guidelines advise to use anticoagulants in patients with CHA2DS2-VASc risk score of >0, but this cut-off and this risk score approach might be reconsidered as patients tend to have lower absolute risks in community based populations.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. van den Ham: Further research should improve risk prediction to reduce overuse of anticoagulation in low stroke risk patients with Atrial fibrillation while, at the same time, guiding the appropriate use in patients at higher risk of stroke.

Citation:

H.A. (Hendrika) van den Ham PharmD (2015). Study Compares Anticoagulation Risk Scores in Atrial Fibrillation MedicalResearch.com