Stroke Risk Should Be Measured Annually in Patients with AF, Researchers Say

By Amy Orciari Herman

Edited by Lorenzo Di Francesco, MD, FACP, FHM

Patients newly diagnosed with atrial fibrillation (AF) who are considered at low risk for stroke based on the CHA₂DS₂-VASc score may warrant risk reassessment each year, according to a brief report in the Annals of Internal Medicine.

Using a Taiwan insurance database, researchers identified nearly 15,000 adults diagnosed with AF between 1997 and 2010 who were deemed low risk — that is, none had comorbidities that would give a CHA₂DS₂-VASc score above 0 (men) or 1 (women). Accordingly, none were prescribed oral anticoagulants or antiplatelets.

During roughly 3 years' follow-up, over a third of the patients developed a comorbidity that would increase their CHA₂DS₂-VASc score and make them eligible for treatment. In particular, 16% of men and women did so in the first year.

The researchers write, "We propose that CHA₂DS₂-VASc scores should be reassessed at least annually in patients with AF so that [oral anticoagulants] can be prescribed in a timely manner for stroke prevention."