کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2720031 1566195 2010 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Improving Stroke Risk Stratification in Atrial Fibrillation
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
پیش نمایش صفحه اول مقاله
Improving Stroke Risk Stratification in Atrial Fibrillation
چکیده انگلیسی

Risk factors for stroke and thromboembolism in patients with atrial fibrillation used in current risk stratification schema are derived largely from analyses of clinical trial cohorts, and the available data depend on the comprehensiveness of trial reports and whether specific risk factors were sought. The most commonly used schema is the Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] (CHADS2) score. Although simple and well validated, some limitations of CHADS2 this schema are apparent. A more recent approach to risk stratification of patients with nonvalvular atrial fibrillation defines “major (definitive)” risk factors (eg, previous stroke/transient ischemic attack and age ≥ 75 years) and “clinically relevant non-major” risk factors (eg, heart failure, hypertension, diabetes, female gender, age 65-75 years, and atherosclerotic vascular disease). This scheme can be expressed as an acronym, CHA2DS2-VASc, denoting Cardiac failure or dysfunction, Hypertension, Age ≥ 75 [Doubled], Diabetes, Stroke [Doubled]–Vascular disease, Age 65-74, and Sex category [Female]), whereby 2 points are assigned for a history of stroke or age 75 years or more and 1 point each is assigned for age 65 to 74 years, a history of hypertension, diabetes, cardiac failure, and vascular disease. Patients with 1 definitive risk factor or a patient with a CHA2DS2-VASc score of 1 or more could be considered for oral anticoagulation, but a patient with a CHA2DS2-VASc score of 0 is truly low risk and could be managed with no antithrombotic therapy. This would simplify our approach to thromboprophylaxis in patients with atrial fibrillation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Medicine - Volume 123, Issue 6, June 2010, Pages 484–488
نویسندگان
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