[Thromboembolic risk in atrial fibrillation: new clinical perspectives].
Prevention of embolic complications is one of the major goals of therapeutic strategy for atrial fibrillation. The embolic risk is related to the presence and nature of underlying heart disease; furthermore cerebrovascular accidents associated with atrial fibrillation occur in a higher percentage in the elderly, representing 6.7% of the total number of cerebrovascular accidents in the 50-to-59-year-old population and 36% in the 80-to-89-year-old population. Anticoagulation with oral vitamin K antagonists, such as warfarin, is highly effective in reducing ischemic stroke in these patients, but some concerns exist about its safety and tolerability, especially in older patients, because of the hemorrhagic risk. Several risk stratification schemes have been developed to evaluate the thromboembolic/hemorrhagic risk profile in the individual patient, but they have shown intrinsic limitations. In this short report we compare different risk stratification schemes to predict thromboembolic risk in atrial fibrillation patients, and we discuss the application of these schemes into clinical practice and the effects on clinical events.
Villani
Giovanni Quinto
GQ
Divisione di Cardiologia, Ospedale Civile "Guglielmo da Saliceto", Piacenza. gqvillani@hotmail.com
Andreoli
Anna Maria
AM
Villani
Matteo
M
Capucci
Alessandro
A
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D018570:Risk Assessment; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D013923:Thromboembolism / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants