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Risk of stroke
Stroke is a serious complication of Atrial Fibrillation that is associated with long-term disability and mortality.3,4 20–30% of all strokes occur in people with atrial fibrillation.1,2 Patients with AF have a 142% increased risk of any stroke and a 133% greater risk of ischemic stroke compared to individuals without AF.5 Stroke is more severe and debilitating in patients with AF than among those who do not have AF.6,7 There are a range of factors that raise the likelihood of stroke among patients with AF, such as older age, the CHA2DS2VASc score is a well-known stroke assessment tool.1,9
Stroke as complication of AF
Atrial Fibrillation (AF or AFib) is a well-known risk factor for stroke through a cardio-embolic mechanism.1 20–30% of all strokes occur in people with Atrial Fibrillation.1,2
Stroke is one of the most serious complications of AF as it is associated with long-term disability and mortality.3,4
Compared to individuals without AF, patients with AF have a 142% increased risk of any stroke and a 133% greater risk of ischemic stroke.
AF not only increases the risk of stroke but the severity. Stroke in patients with AF is also more severe and debilitating than in patients who do not have the condition.6,7 Immediately after a stroke, patients with AF have greater neurological impairment and functional disability than those without AF.6
Calculate your patient's score for AF stroke risk
CHA2DS2-VASc allows healthcare professionals to quickly assess, interpret and explain to patients their stroke risk and a recommended therapy. Each risk factor receives 1 point except age ≥ 75 and stroke/TIA which receive 2 points. The more points on the score, the higher the annual stroke risk.
The 2016 European Society of Cardiology (ESC) guidelines recommend using the CHA2DS2-VASc score to estimate stroke risk in AF patients. Click through to calculate your patient’s stroke risk.
European Stroke Association Guidelines
Deaths due to stroke can largely be avoided by anticoagulation therapy.1 A non-vitamin K antagonist oral (NOAC) is preferred, except in patients with moderate to severe mitral stenosis, mechanical heart valves or severe kidney disease.1
Hypertension is a stroke risk factor in AF and uncontrolled high blood pressure enhances the risk of stroke and bleeding events, which may lead to recurrent AF – so blood pressure control should form an integral part of management of AF.1
The highest risk of stroke recurrence is in the early phase after a first stroke or transient ischemic attack (TIA) and anticoagulation therapy should be initiated according to the European Stroke Association Guidelines.
1. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D et al. (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37 (38): 2893-2962. 2. Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S (2014) Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol 6 213-220. 3. Menke J, Luthje L, Kastrup A, Larsen J (2010) Thromboembolism in atrial fibrillation. Am J Cardiol 105 (4): 502-510. 4. Hillis AE, Tippett DC (2014) Stroke Recovery: Surprising Influences and Residual Consequences. Advances in Medicine 2014 1-10. 5. Odutayo A, Wong CX, Hsiao AJ, Hopewell S, Altman DG et al. (2016) Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. Bmj 354 i4482. 6. Hannon N, Sheehan O, Kelly L, Marnane M, Merwick A et al. (2010) Stroke associated with atrial fibrillation--incidence and early outcomes in the north Dublin population stroke study. Cerebrovasc Dis 29 (1): 43-49. 7. Andrew NE, Thrift AG, Cadilhac DA (2013) The prevalence, impact and economic implications of atrial fibrillation in stroke: what progress has been made? Neuroepidemiology 40 (4): 227-239. 8. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. (2010) Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation Chest. ;137(2):263-72. doi: 10.1378/chest.09-1584. Epub 2009 Sep 17. 9. Bassand JP, Accetta G, Al Mahmeed W, Corbalan R, Eikelboom J et al. (2018) Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation. PLoS One 13 (1): e0191592.
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