Document Detail

Reliable Identification of 'Truly Low' Thromboembolic Risk in Patients Initially Diagnosed with 'Lone' Atrial Fibrillation: The Belgrade Atrial Fibrillation Study.
MedLine Citation:
PMID:  22319004     Owner:  NLM     Status:  Publisher    
BACKGROUND: -The CHA(2)DS(2)-VASc schema has recently been introduced to complement the CHADS(2) score and improve the identification of atrial fibrillation (AF) patients at 'truly low risk' for thromboembolism. We tested the predictive ability of the CHA(2)DS(2)-VASc, CHADS(2) and van Walraven risk stratification schemes in a cohort of 'lone' AF patients with a 12-year follow-up. METHODS AND RESULTS: -We conducted a registry-based, observational cohort study of 345 patients initially diagnosed with 'lone' AF between 1992 and 2007. At baseline, all patients had the CHADS(2) and van Walraven scores of 0, and 262(75.9%) had a CHA(2)DS(2)-VASc score=0. During follow-up (or within a year prior to stroke), 228 (66.1%), 234 (67.8%) and 150 patients (43.5%) retained the CHADS(2), van Walraven and CHA(2)DS(2)-VASc scores of 0, respectively. The overall rate of ischemic stroke was 0.19 (95%CI:0.18-0.20) per 100 patient-years. In the multivariable analysis, only the CHA(2)DS(2)-VASc score of 0 was significantly related to the absence of stroke (OR 5.1, 95%CI:1.5-16.8, p=0.008). Only the CHA(2)DS(2)-VASc score had a significant prediction ability (c-statistic 0.72 [0.61-0.84], p=0.031). CONCLUSIONS: -The CHA(2)DS(2)-VASc score reliably identified the 'lone' AF patients who were at 'truly low risk' for thromboembolism, and was the only tested risk stratification scheme with a significant predictive ability for thromboembolism amongst lone AF patients.
Tatjana S Potpara; Marija M Polovina; Marina M Licina; Jelena M Marinkovic; Milica S Prostran; Gregory Y H Lip
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-8
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 University of Belgrade & Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia;
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