The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA2DS2-VASc Score
Open accessAbstract
Background Even a single additional stroke risk factor in patients with atrial fibrillation may confer a risk of stroke. However, there is no consensus on how best to treat these patients.Objectives Our objective was to investigate the risk of stroke and bleeding and the impact of antithrombotic therapy among low-risk patients, i.e., with 0 or 1 CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category) score risk factor.Methods The nationwide cohort for this study was established by linking data from the Danish Civil Registration System, the Danish National Patient Register, and the Danish National Prescription Registry. We studied 39,400 patients discharged with incident nonvalvular atrial fibrillation with 0 or 1 CHA2DS2-VASc risk factor; 23,572 were not treated, 5,353 were initiated on aspirin, and 10,475 were initiated on warfarin.Results Stroke event rates for untreated low-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) were 0.49 per 100 person-years at 1 year and 0.47 per 100 person-years at full follow-up (intention-to-treat). Bleeding event rates among untreated low-risk patients were 1.08 per 100 person-years at 1 year and 0.97 at full follow-up. The presence of 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]) among untreated patients increased the stroke rate at 1 year to 1.55 per 100 person-years, representing a significant 3.01-fold increase. At the 1-year follow-up, bleeding increased 2.35-fold, and death increased 3.12-fold.Conclusions Low-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
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“In many of these patients, anticoagulation seems to provide a clinical benefit.[371][372][373][374][375]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [373]
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Gage, B. F., Waterman, A. D., Shannon, W., Boechler, M., Rich, M. W., & Radford, M. J. (2001) · JAMA · doi:10.1001/jama.285.22.2864 · Cited by 4,832
Hart, R. G., Pearce, L. A., & Aguilar, M. I. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-12-200706190-00007 · Cited by 4,793 · cited 3×
“In randomized trials, oral anticoagulation significantly reduces stroke and all-cause mortality, compared with use of control/placebo (1), and similar trends were seen in the current study for patients with $1 additional stroke risk factor.”
Background2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · EP Europace · doi:10.1093/europace/eus305 · Cited by 3,823
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., Conti, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.03.022 · Cited by 2,955
Apixaban in patients with atrial fibrillation
Connolly, S. J., Eikelboom, J., Joyner, C., Diener, H.-C., Hart, R., Golitsyn, S., Flaker, G., Avezum, A., Hohnloser, S. H., Diaz, R., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1007432 · Cited by 2,483
Evaluating medication effects outside of clinical trials: new-user designs
Ray, W. A. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg231 · Cited by 1,646
Antithrombotic Therapy for Atrial Fibrillation
You, J. J., Singer, D. E., Howard, P. A., Lane, D. A., Eckman, M. H., Fang, M. C., Hylek, E. M., Schulman, S., Go, A. S., Hughes, M., et al. (2012) · CHEST Journal · doi:10.1378/chest.11-2304 · Cited by 933
The Net Clinical Benefit of Warfarin Anticoagulation in Atrial Fibrillation
Singer, D. E., Chang, Y., Fang, M. C., Borowsky, L. H., Pomernacki, N. K., Udaltsova, N., & Go, A. S. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-5-200909010-00003 · Cited by 655
Skanes, A. C., Healey, J. S., Cairns, J. A., Dorian, P., Gillis, A. M., McMurtry, M. S., Mitchell, L. B., Verma, A., & Nattel, S. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.01.021 · Cited by 493
Olesen, J. B., Torp-Pedersen, C. T., Hansen, M. L., & Lip, G. Y. H. (2012) · Thrombosis and Haemostasis · doi:10.1160/th12-03-0175 · Cited by 484
Friberg, L., Rosenqvist, M., & Lip, G. Y. H. (2012) · Circulation · doi:10.1161/circulationaha.111.055079 · Cited by 454
Self-citationLip, G., Lindhardsen, J., Lane, D., Ahlehoff, O., Hansen, M., Raunsø, J., Tolstrup, J., Hansen, P., Gislason, G., Torp-Pedersen, C., et al. (2011) · Thrombosis and Haemostasis · doi:10.1160/th11-05-0364 · Cited by 428
Vitamin K antagonists in heart disease: Current status and perspectives (Section III)
Husted, S., Wallentin, L. C., Andreotti, F., Arnesen, H., Bachmann, F., Baigent, C., Huber, K., Jespersen, J., Kristensen, S. D., Lip, G. Y. H., et al. (2013) · Thrombosis and Haemostasis · doi:10.1160/th13-06-0443 · Cited by 373
Anderson, J. L., Halperin, J. L., Albert, N. M., Bozkurt, B., Brindis, R. G., Curtis, L. H., DeMets, D. L., Guyton, R. A., Hochman, J. S., Kovacs, R. J., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.02.001 · Cited by 311
Banerjee, A., Lane, D. A., Torp-Pedersen, C. T., & Lip, G. Y. H. (2011) · Thrombosis and Haemostasis · doi:10.1160/th11-11-0784 · Cited by 300
Eckman, M. H., Singer, D. E., Rosand, J. M., & Greenberg, S. M. (2010) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.110.958108 · Cited by 280
Alcohol and Risk of Atrial Fibrillation or Flutter
Frost, L., & Vestergaard, P. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.18.1993 · Cited by 211
Gallego, P., Roldan, V., Marín, F., Romera, M., Valdés, M., Vicente, V., & Lip, G. Y. H. (2013) · Thrombosis and Haemostasis · doi:10.1160/th13-07-0556 · Cited by 187
Stroke and Thromboembolism in Atrial Fibrillation
Pisters, R., Lane, D. A., Marín, F. R., Camm, A. J., & Lip, G. Y. H. (2012) · Circulation Journal · doi:10.1253/circj.cj-12-1036 · Cited by 162
Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why?
Lip, G. Y. H. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs435 · Cited by 161
Non-vitamin K antagonist oral anticoagulants (NOACs): No longer new or novel
Caterina, R. D., Andreotti, F., Arnesen, H., Bachmann, F., Huber, K., Jespersen, J., Kristensen, S. D., Lip, G. Y. H., Morais, J., Rasmussen, L., et al. (2014) · Thrombosis and Haemostasis · doi:10.1160/th14-03-0228 · Cited by 141
Evaluation of patients’ attitudes towards stroke prevention and bleeding risk in atrial fibrillation
Regpala, S., Lacombe, S., Sharma, M., Gibbens, S., Ball, D., Francis, K., & LaHaye, S. (2013) · Thrombosis and Haemostasis · doi:10.1160/th13-05-0424 · Cited by 130
Schmidt, M., Hallas, J., & Friis, S. (2014) · Clinical Epidemiology · doi:10.2147/clep.s59156 · Cited by 115
Gorin, L., Nonin, E., de Labriolle, A., Haguenoer, K., Cosnay, P., Babuty, D., Charbonnier, B., & Fauchier, L. (2010) · Thrombosis and Haemostasis · doi:10.1160/th09-10-0746 · Cited by 106
Lip, G. Y. H., & Lane, D. A. (2014) · Thrombosis and Haemostasis · doi:10.1160/th14-01-0063 · Cited by 68
Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1
Huang, D., ANGUO, L., Yue, W., Yin, L., Tse, H., & Siu, C. (2014) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12445 · Cited by 48
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403
Stroke prevention in atrial fibrillation
Freedman, B., Potpara, T., & Lip, G. Y. H. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31257-0 · Cited by 484
Yao, X., Abraham, N. S., Alexander, G. C., Crown, W. H., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., & Noseworthy, P. A. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.003074 · Cited by 456
“Estimates of baseline untreated stroke risk in this low-risk population vary in the literature.(13,46,47) We found that adherence to anticoagulation was not associated with a significant reduction in stroke in patients with CHA2DS2-VASc score 0 or 1, suggesting that the stroke risk is not easily modified in low-risk p…”
Background
Metadata
- Authors
- Lip, G. Y. H., Skjøth, F., Rasmussen, L. H., & Larsen, T. B.
- Affiliations
- Birmingham City Hospital (GB)
- Aalborg University Hospital (DK)
- Aalborg University (DK)
- Corresponding author
- Lip, Gregory Y.H.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 65
- Issue
- 14
- Pages
- 1385-1394
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2161837371
- Cited by
- 171
- References
- 26
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 9 · 2022: 5 · 2021: 9 · 2020: 7 · 2019: 17 · 2018: 16 · 2017: 21 · 2016: 43 · 2015: 24
- FWCI
- 25.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Funders
- AstraZeneca
- Sanofi
- Astellas Pharma
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- non-valvular atrial fibrillation, CHA2DS2-VASc score, stroke risk, bleeding risk, oral anticoagulation, warfarin, aspirin, antithrombotic therapy, low-risk patients, stroke prevention, mortality, sex differences, stroke risk factors, civil registration, patient registry, incident atrial fibrillation
- MeSH terms
- Administration, Oral, Aged, Anticoagulants, Aspirin, Atrial Fibrillation, Blood Coagulation, Denmark, Female, Humans, Male, Registries, Risk Factors, Cohort Studies, Stroke
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