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Researchers identify risk factors, protective agent for thromboembolism in anticoagulated patients with AF
Lip G. Stroke. 2010;41:2731-2738.
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Coronary artery disease, smoking and stroke were among the risk factors for thromboembolism in patients with atrial fibrillation given an anticoagulant, whereas alcohol use protected against the condition, new data indicated.
The study included a cohort of patients (n=7,329) with AF who were using either warfarin or ximelagatran. Researchers tested the predictive value of contemporary risk stratification schemes — including CHADS2, Framingham, NICE 2006, ACC/AHA/ESC 2006 and CHA2DS2-VASc — to identify patients at high risk for stroke despite anticoagulation.
According to multivariate analysis, significant predictors of thromboembolism included stroke/transient ischemic attack (HR=2.24; P<.001), CAD (HR=1.52; P=.0047), smoking (HR=2.10; P=.0005) and age of at least 75 years (HR=1.77; P=.0002); however, alcohol use was found to lower risk for thromboembolism (HR=0.70; P=.02).
Additional analysis revealed CHA2DS2-VASc as detecting the highest rate of patients at risk for the condition (94.2%), whereas most other schemes detected only two-thirds of the population at risk. CHA2DS2-VASc also had the highest HR (3.75) of the tested schemes.
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