Anticoagulation in Atrial Fibrillation: The U.S. Wins for Now

The most feared complication of atrial fibrillation (AF) is a stroke, yet not all AF patients have the same risk for stroke. Both U.S. guidelines (NEJM JW Cardiol May 19 2014) and European guidelines (Europace 2012; 14:1385) base risk for thromboembolic events on the CHA₂DS₂-VASc score. However, the European guidelines call for anticoagulation for individuals with a score of 1 or more (excluding females with a score of 1), while the U.S. guidelines urge anticoagulation for those with a score of 2 or more. Researchers have now assessed stroke risk in individuals with AF and a CHA₂DS₂-VASc score of 1 from the Swedish Nationwide Health Registry. The researchers compared patient data from this registry with strokes in the National Patient Regis…