Atrial fibrillation (AF) is one of major problems of the contemporary
cardiology. Ischaemic stroke is a common complication of the AF, and effective
prophylaxis requires treatment with oral anticoagulants. The purpose of this current review article is
to provide an overview of the various stroke and bleeding risk assessment scores
that help decision making with respect to thromboprophylaxis.
Particular focus is made on the currently guideline-recommended stroke
and bleeding risk scores, such as CHA2DS2-VASc
(congestive heart failure or left ventricular dysfunction, hypertension, age
≥75, diabetes, stroke, vascular disease, age 65–74 and sex category [female])
and HAS-BLED (uncontrolled hypertension, abnormal renal/liver function, stroke,
bleeding history or predisposition, labile international normalized ratio,
elderly [e.g. age >65, frail condition], drugs [e.g. aspirin, nonsteroidal
anti-inflammatory drugs]/excessive alcohol) is made. Future directions for improvement of predictive
ability of risk assessment with clinical factors and biomarkers are also
discussed.
Credits: Mikhail S Dzeshka; Gregory Y.H. Lip