scholarly journals Status of CHADS2 and CHA2DS2-VASc Scores in Predicting Risk of Stroke and its Prevention in Iraqi Patients with Atrial Fibrillation

2019 ◽  
Vol 28 (1) ◽  
pp. 101-105
Author(s):  
Mohanad Y. Al-Radeef
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Oral Anticoagulants ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Elevated Risk ◽  
Current Status ◽  
Sectional Study ◽  
Cross Sectional

Atrial fibrillation is associates with elevated risk of stroke. The simplest stroke risk assessment schemes are CHADS2 and CHA2DS2-VASc score. Aspirin and oral anticoagulants are recommended for stroke prevention in such patients. The aim of this study was to  assess status of CHADS2 and CHA2DS2-VASc scores in Iraqi atrial fibrillation patients and to report current status of stroke prevention in these patients with either warfarin or aspirin in relation to these scores. This prospective cross-sectional study was carried out at Tikrit, Samarra, Sharqat, Baquba, and AL-Numaan hospitals from July 2017 to October 2017. CHADS2 and CHA2DS2-VASc scores were manually calculated. One hundred patients were participated, 48 were men and 52 were women. Their mean age was 62.56 ± 14.36 years. Permanent type of atrial fibrillation, palpitation, and hypertension were the most diagnosed type, symptom and comorbidity recorded in this study respectively. Average scores of CHADS2 and CHA2DS2-VASc were 2.34 ± 1.39 and 4.1 ± 2.05, respectively. These scores were not calculated for these patients in hospital setting. Aspirin and warfarin were prescribed regardless to these scores. The result of this study indicated that CHADS2 and CHA2DS2-VASc scores were often neglected in hospitals; and aspirin is still widely used as a strategy to minimize the risk of stroke. Keywords: Atrial fibrillation, CHADS2, CHA2DS2-VASc, aspirin, warfarin.

scholarly journals Status of CHADS2 and CHA2DS2-VASc Scores in Predicting Risk of Stroke and its Prevention in Iraqi Patients with Atrial Fibrillation

2019 ◽  
Vol 28 (1) ◽  
pp. 101-106
Author(s):  
Mohanad Yasir Radeef
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Oral Anticoagulants ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Elevated Risk ◽  
Current Status ◽  
Sectional Study ◽  
Cross Sectional

Atrial fibrillation is associates with elevated risk of stroke. The simplest stroke risk assessment schemes are CHADS2 and CHA2DS2-VASc score. Aspirin and oral anticoagulants are recommended for stroke prevention in such patients. The aim of this study was to  assess status of CHADS2 and CHA2DS2-VASc scores in Iraqi atrial fibrillation patients and to report current status of stroke prevention in these patients with either warfarin or aspirin in relation to these scores. This prospective cross-sectional study was carried out at Tikrit, Samarra, Sharqat, Baquba, and AL-Numaan hospitals from July 2017 to October 2017. CHADS2 and CHA2DS2-VASc scores were manually calculated. One hundred patients were participated, 48 were men and 52 were women. Their mean age was 62.56 ± 14.36 years. Permanent type of atrial fibrillation, palpitation, and hypertension were the most diagnosed type, symptom and comorbidity recorded in this study respectively. Average scores of CHADS2 and CHA2DS2-VASc were 2.34 ± 1.39 and 4.1 ± 2.05, respectively. These scores were not calculated for these patients in hospital setting. Aspirin and warfarin were prescribed regardless to these scores. The result of this study indicated that CHADS2 and CHA2DS2-VASc scores were often neglected in hospitals; and aspirin is still widely used as a strategy to minimize the risk of stroke.

Presentation of atrial fibrillation and its management by cardiologists in the ambulatory and hospital setting: MOVE cross-sectional study

2011 ◽  
Vol 27 (5) ◽  
pp. 995-1003 ◽  
Author(s):  
Hendrik Bonnemeier ◽  
Ralph F. Bosch ◽  
Annette Kohlhaußen ◽  
Ludger Rosin ◽  
Stefan N. Willich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Evaluating Physician Adherence to Antithrombotic Recommendations in Patients with Atrial Fibrillation: A Pathway to Better Medical Education

2020 ◽  
Vol 17 (11) ◽  
pp. 4008 ◽  
Author(s):  
Ştefan Cristian Vesa ◽  
Sonia Irina Vlaicu ◽  
Octavia Sabin ◽  
Vitalie Văcăraș ◽  
Sorin Crișan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Score ◽  
Stroke Risk ◽  
Oral Anticoagulants ◽  
Demographic Data ◽  
Bleeding Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Physician Adherence

Background: Atrial fibrillation is a major health problem due to the stroke risk associated with it. To reduce stroke risk, oral anticoagulants (OAC) are prescribed using the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years; Diabetes Mellitus; Stroke; Vascular disease; Age 65–74 years; Sex category) risk score, a clinical probability assessment that includes a combination of risk factors predicting the probability of a stroke. Not all patients with high risk are receiving this treatment. The aim of this study was to assess physician adherence to clinical guidelines concerning the OAC treatment and to identify the factors that were associated with the decision to prescribe it. Methods: Registry data from 784 patients with non-valvular atrial fibrillation were evaluated in this retrospective cross-sectional study. Demographic data, subtype of AF, comorbidities associated with higher stroke and bleeding risk, and antithrombotic treatment received were recorded. We compared stroke and bleeding risk in patients with and without OAC treatment to determine if the clinicians followed guidelines: prescribed when necessary and abstained when not needed. Results: OAC treatment was administered in 617 (78.7%) patients. Of the 167 patients who did not receive OAC, 161 (96.4%) were undertreated according to their risk score, as opposed to those who received OAC in which the percentage of overtreated was 3.2%. Most undertreated patients (60.5%, p < 0.001) were with paroxysmal atrial fibrillation subtype. Conclusions: The decision to use anticoagulants for stroke prevention was based on the type of atrial fibrillation, rather than on the risk of stroke as quantified by CHA2DS2-VASc as per the recommended guidelines.

scholarly journals Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)

2021 ◽  
Vol 18 (5) ◽  
pp. 2244
Author(s):  
M. Rosa Dalmau Llorca ◽  
Carina Aguilar Martín ◽  
Noèlia Carrasco-Querol ◽  
Zojaina Hernández Rojas ◽  
Emma Forcadell Drago ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Real World ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data

Background: Oral anticoagulants (OAs) are the treatment to prevent stroke in atrial fibrillation (AF). Anticoagulant treatment choice in non-valvular atrial fibrillation (NVAF) must be individualized, taking current guidelines into account. Adequacy of anticoagulant therapy under the current criteria for NVAF in real-world primary care is presented. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in Primary Care (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centers in 2018. Results: In total, 41,430 (68%) were treated with vitamin K antagonists (VKAs) and 19,548 (32%) NVAF with direct-acting oral anticoagulants (DOACs). Inadequate prescription was estimated to be 36.0% and 67.6%, respectively. Most DOAC inadequacy (77.3%) was due to it being prescribed as a first-line anticoagulant when there was no history of thromboembolic events or intracranial hemorrhage (ICH). A total of 22.1% had missing estimated glomerular filtration rate (eGFR) values. Common causes of inadequate VKA prescription were poor control of time in therapeutic range (TTR) (98.8%) and ICH (2.2%). Conclusions: Poor adequacy to current criteria was observed, being inadequacy higher in DOACs than in VKAs. TTR and GFR should be routinely calculated in electronic health records (EHR) to facilitate decision-making and patient safety.

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