Net benefit of anticoagulants for A-fib varies with stroke rate

Net benefit of anticoagulants for A-fib varies with stroke rate

(HealthDay)—There is variation in the net clinical benefit of anticoagulants based on variation in published atrial fibrillation (AF) stroke rates, according to a study published online Sept. 25 in the Annals of Internal Medicine.

Sachin J. Shah, M.D., M.P.H., from the University of California in San Francisco, and colleagues examined the effect of variation in published AF stroke rates on the net clinical benefit of among 33,434 adults with incident AF.

The researchers found that 27,179 of the patients had a , hypertension, age, diabetes, stroke, and vascular disease (CHA2DS2-VASc) score of two or more. For these patients, the population benefit of warfarin anticoagulation was least using stroke rates from the Anticoagulation and Risk factors in Atrial Fibrillation (ATRIA) study and greatest using those from the Danish National Patient Registry (6,290 versus 24,110 quality-adjusted life-years). The optimal CHA2DS2-VASc score threshold for anticoagulation was three or more, two or more, one or more, and zero using stroke rates from ATRIA, the Swedish AF cohort study, the Stroke Prevention using Oral Thrombin Inhibitor in Atrial Fibrillation study, and the Danish National Patient Registry, respectively. Optimal CHA2DS2-VASc score thresholds were reduced after accounting for lower rates of non-vitamin K antagonist oral anticoagulants-associated intracranial hemorrhage.

"Guidelines should better reflect the uncertainty in current thresholds of risk score for recommending anticoagulation," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.


Explore further

Follow-up delta CHA2DS2-VASc score better predicts CVA in A-fib

More information: Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Journal information: Annals of Internal Medicine

Copyright © 2018 HealthDay. All rights reserved.

Citation: Net benefit of anticoagulants for A-fib varies with stroke rate (2018, September 25) retrieved 13 December 2019 from https://medicalxpress.com/news/2018-09-net-benefit-anticoagulants-a-fib-varies.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
 shares

Feedback to editors

User comments