OPEN IN READ APP
JOURNAL ARTICLE

Is an Oral Anticoagulant Necessary for Young Atrial Fibrillation Patients With a CHA2DS2-VASc Score of 1 (Men) or 2 (Women)?

Yuan Hung, Tze-Fan Chao, Chia-Jen Liu, Ta-Chuan Tuan, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Jo-Nan Liao, Fa-Po Chung, Wen-Yu Lin, Wei-Shiang Lin, Shu-Meng Cheng, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen
Journal of the American Heart Association 2016 October 4, 5 (10)
27702803

BACKGROUND: Recent studies demonstrated that oral anticoagulants (OACs) should be considered for patients with atrial fibrillation and 1 risk factor in addition to sex. Because age is an important determinant of ischemic stroke, the strategy for stroke prevention may be different for these patients in different age strata. The aim of this study was to investigate whether OACs should be considered for patients aged 20 to 49 years with atrial fibrillation and a CHA2 DS2 -VASc score of 1 (men) or 2 (women).

METHODS AND RESULTS: Using the Taiwan National Health Insurance Research Database, 7374 male patients with atrial fibrillation and a CHA2 DS2 -VASc score of 1 and 4461 female patients with atrial fibrillation and a CHA2 DS2 -VASc score of 2 and all without antithrombotic therapies were identified and stratified into 3 groups by age. The threshold for the initiation of OACs for stroke prevention was set at a stroke rate of 1.7% per year for warfarin and 0.9% per year for non-vitamin K antagonist OACs. Among male patients aged 20 to 49 years with a CHA2 DS2 -VASc score of 1, the risk of ischemic stroke was 1.30% per year and ranged from 0.94% per year for those with hypertension to 1.71% for those with congestive heart failure. Among female patients aged 20 to 49 years with a CHA2 DS2 -VASc score of 2, the risk of ischemic stroke was 1.40% per year and ranged from 1.11% per year for those with hypertension to 1.67% for those with congestive heart failure.

CONCLUSIONS: For atrial fibrillation patients aged 20 to 49 years with 1 risk factor in addition to sex, non-vitamin K antagonist OACs should be considered for stroke prevention to minimize the risk of a potentially fatal or disabling event.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Responses

Sort by: Most RecentHighest Rated

Fernanda Carballo

Thanks for this article in a free downloud mode...

1

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
27702803
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"