No change in practice is warranted, because patients at highest bleeding risk are also the most likely to have net benefit from anticoagulation.
The CHA2DS2-VASc is a validated score that predicts stroke risk in patients with nonvalvular atrial fibrillation (AF) based on Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥75 years, Diabetes, previous Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65 to 74 years, and female Sex). Patients with higher scores are at higher risk for stroke, and anticoagulation is recommended for patients with score ≥2 and for some patients with a score of 1 (NEJM JW Gen Med Jun 1 2016 and J Am Coll Cardiol 2015; 65:225, 233, 635, and 1385). Investigators reviewed a database from the from the Department of Defense Military Health System to determine whether bleeding risk increased with increasing score…
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals