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Ding, Wern Yew; Blomström-Lundqvist, Carina; Fauchier, Laurent; Marin, Francisco; Potpara, Tatjana S; Boriani, Giuseppe; Lip, Gregory Y H; Boriani, G; Lip, GYH; Tavazzi, L; Maggioni, A P; Dan, G-A; Potpara, T; Nabauer, M; Marin, F; Kalarus, Z; Fauchier, L; Goda, A; Mairesse, G; Shalganov, T; Antoniades, L; Taborsky, M; Riahi, S; Muda, P; [...]

Contemporary management of atrial fibrillation and the predicted vs. absolute risk of ischaemic stroke despite treatment: a report from ESC-EHRA EORP-AF Long-Term General Registry

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  • Media type: E-Article
  • Title: Contemporary management of atrial fibrillation and the predicted vs. absolute risk of ischaemic stroke despite treatment: a report from ESC-EHRA EORP-AF Long-Term General Registry
  • Contributor: Ding, Wern Yew; Blomström-Lundqvist, Carina; Fauchier, Laurent; Marin, Francisco; Potpara, Tatjana S; Boriani, Giuseppe; Lip, Gregory Y H; Boriani, G; Lip, GYH; Tavazzi, L; Maggioni, A P; Dan, G-A; Potpara, T; Nabauer, M; Marin, F; Kalarus, Z; Fauchier, L; Goda, A; Mairesse, G; Shalganov, T; Antoniades, L; Taborsky, M; Riahi, S; Muda, P; [...]
  • imprint: Oxford University Press (OUP), 2023
  • Published in: EP Europace
  • Language: English
  • DOI: 10.1093/europace/euac214
  • ISSN: 1099-5129; 1532-2092
  • Keywords: Physiology (medical) ; Cardiology and Cardiovascular Medicine
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Risk stratification in patients with atrial fibrillation (AF) is important to facilitate guideline-directed therapies. The Calculator of Absolute Stroke Risk (CARS) scheme enables an individualized estimation of 1-year absolute risk of stroke in AF. We aimed to investigate the predicted and absolute risks of ischaemic stroke, and evaluate whether CARS (and CHA2DS2-VASc score) may be useful for identifying high risk patients with AF despite contemporary treatment.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We utilized the EORP-AF General Long-Term Registry which prospectively enrolled patients with AF from 250 centres across 27 participating European countries. Patients with sufficient data to determine CARS and CHA2DS2-VASc score, and reported outcomes of ischaemic stroke were included in this analysis. The primary outcome of ischaemic stroke was recorded over a 2-year follow-up period.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 9444 patients were included (mean age 69.1 [±11.4] years; 3776 [40.0%] females). There was a high uptake (87.9%) of anticoagulation therapy, predominantly with vitamin K antagonist (50.0%). Over a mean follow-up period of 24 months, there were a total of 101 (1.1%) ischaemic stroke events. In the entire cohort, the median CARS and absolute annual risks of ischaemic stroke were 2.60 (IQR 1.60–4.00) and 0.53% (95%CI 0.43–0.64%), respectively. There was no statistical difference between the predictive performance of CARS and CHA2DS2-VASc score (0.621 [95%CI 0.563–0.678] vs. 0.626 [95%CI 0.573–0.680], P = 0.725).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Contemporary management of AF was associated with a low risk of ischaemic stroke. CARS and CHA2DS2-VASc score may be useful to identify high risk patients despite treatment who may benefit from more aggressive treatment and follow-up.</jats:p></jats:sec>
  • Access State: Open Access