title: Impact of new criteria for anticoagulant treatment in atrial fibrillation.
abstract: OBJECTIVE
  The guidelines for the management of atrial fibrillation (AF) incorporate new risk factors for thromboembolism, trying to de-emphasize the use of the 'low', 'moderate', and 'high' risk categories. The objective of this study was to determine the impact of the new scheme CHA₂DS₂-VASc and of the new recommendations for oral anticoagulation (OAC) in a contemporary sample of patients with AF seen by primary physicians and cardiologists.
  
  
  METHODS
  Multicenter, observational, cross-sectional study on the epidemiology of hypertension and its control, designed by the arterial hypertension department. Each researcher enrolled the first 6 consenting patients who came for examination during a 5-day period.
  
  
  RESULTS
  Of 25 137 individuals recruited, 1544 were diagnosed with AF. The vast majority of the sample had a CHADS₂ score ≥2 (77.3%). Individuals with a risk score lower than 2 were categorized according to the CHA₂DS₂-VASc score: 14.4% were aged 75 years or older (CHA₂DS₂-VASc=2). Of those younger than 75, 42.3% had a CHA₂DS₂-VASc=2; 23.7% CHA₂DS₂-VASc=3, and 1.1% CHA₂DS₂-VASc=4. This means that the 85.1% of the patients with a CHADS₂ score <2 and no contraindications are indicated for OAC.
  
  
  CONCLUSIONS
  The new recommendations will result in a significant increase in patients with indications for OAC, at the expense of those previously characterized as low-to-moderate risk. Therefore, patients at risk of thromboembolic events must be identified, although an evaluation of bleeding risk should be part of the patient assessment before starting anticoagulation.
authors.affiliation: Heart Rhythm Management Centre, University Hospital Brussels-UZ Brussels, Belgium. mrodrigu@uzbrussel.be
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez-Mañero
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-González
authors.forename: José
authors.initials: J
authors.lastname: Moreno-Arribas
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Martínez
authors.forename: Pilar
authors.initials: P
authors.lastname: Mazón
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.forename: Juan
authors.initials: J
authors.lastname: Cosín
authors.forename: Iñaki
authors.initials: I
authors.lastname: Lekuona
authors.forename: Enrique
authors.initials: E
authors.lastname: Galve
authors.forename: José R
authors.initials: JR
authors.lastname: González-Juanatey
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants