title: Stroke Risk Perception in Atrial Fibrillation Patients is not Associated with Clinical Stroke Risk.
abstract: BACKGROUND
  Clinical risk stratification models, such as the CHA2DS2-VASc, are used to assess stroke risk in atrial fibrillation (AF) patients. No study has yet investigated whether and to which extent these patients have a realistic perception of their personal stroke risk. The purpose of this study was to investigate and describe the association between AF patients' stroke risk perception and clinical stroke risk.
  
  
  METHODS
  In an observational cross-sectional study design, we surveyed 178 AF patients with a mean age of 70.6 years (SD 8.3) in stable anticoagulant treatment (65% treatment duration >12 months). Clinical stroke risk was scored through the CHA2DS2-VASc, and patients rated their perceived personal stroke risk on a 7-point Likert scale.
  
  
  RESULTS
  There was no significant association between clinical stroke risk assessment and patients' stroke risk perception (rho = .025; P = .741). Approximately 60% of the high-risk patients had an unrealistic perception of their own stroke risk, and there was no significant increase in risk perception from those with a lower compared with a higher risk factor load (χ(2) = .010; P = .522).
  
  
  CONCLUSIONS
  Considering possible negative implications in terms of lack of motivation for lifestyle behavior change and adequate adherence to the treatment and monitoring of vitamin K antagonist, the apparent underestimation of risk by large subgroups warrants attention and needs further investigation with regard to possible behavioral consequences.
authors.affiliation: Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark. Electronic address: afournaise@health.sdu.dk.
authors.forename: Anders
authors.initials: A
authors.lastname: Fournaise
authors.affiliation: Unit for Thrombosis Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark; Department of Clinical Biochemistry, Hospital of South West Denmark, Esbjerg, Denmark.
authors.forename: Jane
authors.initials: J
authors.lastname: Skov
authors.affiliation: Unit for Thrombosis Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark; Department of Clinical Biochemistry, Hospital of South West Denmark, Esbjerg, Denmark.
authors.forename: Else-Marie
authors.initials: EM
authors.lastname: Bladbjerg
authors.affiliation: Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Leppin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D003718:Denmark; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010465:Perception; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants