The Effect and Safety of the Antithrombotic Therapies in Patients with Atrial Fibrillation and CHADS2 Score 1

Lee, Byung Ho; Park, Jae Seok; Park, Jae Hyung; Park, Jong Seung; Kwak, Jae Jin; Hwang, Eung-Soo; Kim, Sook Kyoung; Choi, Donghoon; Kim, Young Hoon; Pak, Hui Nam

doi:10.1111/j.1540-8167.2009.01661.x

Cited by 42 publications

(35 citation statements)

References 35 publications

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“…CHADS2 and CHA2DS2VASc scoring systems are used to stratify the risk in patients as low, moderate and high. Previous trials have demonstated that HF carries a higher risk for thromboembolism compared to other risk factors in these scoring systems (130)(131)(132)(133). Therefore, CHADS2 and CHA2DS2VASc scores may underestimate the real risk in patients with HF.…”

Section: What Precautions Should Be Taken In Risk Stratification and mentioning

confidence: 94%

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Çavuşoğlu

Altay²,

Ekmekçi³

et al. 2015

Anatol J Cardiol

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Practical approaches for the treatment of chronic heart failure:Frequently asked questions, overlooked points and controversial issues in current clinical practiceHeart failure (HF) is a progressive disorder associated with impaired quality of life, high morbidity, mortality and frequent hospitalization and affects millions of people from all around the world. Despite further improvements in HF therapy, mortality and morbidity remains to be very high. The life-long treatment, frequent hospitalization, and sophisticated and very expensive device therapies for HF also leads a substantial economic burden on the health care system. Therefore, implementation of evidence-based guideline-recommended therapy is very important to overcome its worse clinical outcomes. However, HF therapy is a long process that has many drawbacks and sometimes HF guidelines cannot answers to every question which rises in everyday clinical practice. In this paper, commonly encountered questions, overlooked points, controversial issues, management strategies in grey zone and problems arising during follow up of a HF patient in real life clinical practice have been addressed in the form of expert opinions based on the available data in the literature. (Anatol J Cardiol 2015: 15 Suppl 2; 1-60)

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Section: What Precautions Should Be Taken In Risk Stratification and mentioning

confidence: 94%

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Çavuşoğlu

Altay²,

Ekmekçi³

et al. 2015

Anatol J Cardiol

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“…In Japan, Inoue et al 27) reported that the annual thromboembolism rates of patients with CHADS2 scores of 0 and 1 were 0.6％ and 2.5％, respectively. Two studies focused on AF patients with a CHADS2 score of 1 showed a substantial reduction in stroke in patients taking VKA compared with patients taking antiplatelet drug or no OAC, although there was a tendency of increased bleeding 12,13) . Recently, the CHA2DS2-VASc score was reported to be inadequate for risk stratification among patients with low CHADS2 scores, because the annual stroke rate was nearly 2％ for patients with a CHADS2 score of 0-1 16,26) .…”

Section: Discussionmentioning

confidence: 99%

“…Recent cohort studies showed that VKA use was associated with a lower stroke rate in patients with CHADS2 score of 1, compared with antiplatelet or no antithrombotic therapy 10,12,13) . .…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes and Anticoagulant Intensity in Japanese Nonvalvular Atrial Fibrillation Patients ≥65 Years of Age with a CHADS2 Score 0-1 and Taking Warfarin

Naganuma

Shiga

Nagao

et al. 2015

Jpn. J. Clin. Pharmacol. Ther.

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Background : Japanese physicians tend to empirically maintain lower-intensity prothrombin time-international normalized ratios (PT-INR) of 1.6-2.6 for most non-valvular atrial fibrillation (NVAF)patients taking warfarin. However, the optimal anticoagulant intensity in Japanese patients with low CHADS2(Congestive heart failure, Hypertension, Age B75, Diabetes, Stroke [doubled])scores is not clear. This study aimed to evaluate the clinical outcome and anticoagulant intensity in Japanese NVAF patients aged B65 years with CHADS2 scores of 0-1 and taking warfarin. Methods : We included 382 consecutive NVAF patients aged B 65 years with CHADS2 scores of 0-1, who took warfarin between 2001 and 2006 (median age, 68 years ; 29.8％ women). This study included a median follow-up period of 54 months (1-154 months). The occurrence of thromboembolic events including ischemic stroke, transient ischemic attack and other systemic embolism, as well as major bleeding events were validated through a medical record review. Results : The incidence of thromboembolic and major bleeding events was both 0.9 per 100 patient-year. All thromboembolic events occurred in patients with a PT-INR ＜2.00. The incidence of major bleeding events increased markedly in patients with a PT-INR B3.00. A HAS-BLED(Hypertension, Abnormal renal／liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly and concomitant Drugs／alcohol)score B3 was a risk for major bleeding(hazard ratio 4.8, 95％ confidence interval 1.6-14.4). A PT-INR of 2.00-2.99 predicted a low incidence of thromboembolic and major bleeding events. Conclusions : Our results showed that a PT-INR of 2.00-2.99 was associated with a low incidence of both thromboembolism and major bleeding in Japanese NVAF patients aged B65 years with CHADS2 score of 0-1 and taking warfarin.

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“…The magnitude of such influence, and even if it really exists, cannot be confirmed or refuted with these data. Lee et al 22 , however, after a mean follow-up of 22 months, have shown in a population of 422 patients with AF and CHADS 2 1 that anticoagulation with vitamin K antagonists reduced the incidence of stroke as compared with that on antiplatelet drugs (4.2% vs. 12.9%, respectively; p = 0.008). The bleeding rate was similar in both groups.…”

Section: Used Both Medications; ( †) Of All Patients With Chads 2 ≥ 2mentioning

confidence: 99%

Estudo transversal das estratégias de tratamento clínico na fibrilação atrial

Oliveira¹,

Mallmann²,

Botelho³

et al. 2012

Arq. Bras. Cardiol.

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The Effect and Safety of the Antithrombotic Therapies in Patients with Atrial Fibrillation and CHADS₂ Score 1

Abstract: In AF patients with CHADS(2) score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.

Cited by 42 publications

References 35 publications

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

<b>Clinical Outcomes and Anticoagulant Intensity in Japanese Nonvalvular Atrial Fibrillation Patients ≥65 Years of Age with a CHADS<sub>2</sub> Score 0-1 and Taking Warfarin</b>

Estudo transversal das estratégias de tratamento clínico na fibrilação atrial

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The Effect and Safety of the Antithrombotic Therapies in Patients with Atrial Fibrillation and CHADS2 Score 1

Abstract: In AF patients with CHADS(2) score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.

Cited by 42 publications

References 35 publications

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

<b>Clinical Outcomes and Anticoagulant Intensity in Japanese Nonvalvular Atrial Fibrillation Patients &ge;65 Years of Age with a CHADS<sub>2</sub> Score 0-1 and Taking Warfarin</b>

Estudo transversal das estratégias de tratamento clínico na fibrilação atrial

Contact Info

Product

Resources

About

The Effect and Safety of the Antithrombotic Therapies in Patients with Atrial Fibrillation and CHADS₂ Score 1

<b>Clinical Outcomes and Anticoagulant Intensity in Japanese Nonvalvular Atrial Fibrillation Patients ≥65 Years of Age with a CHADS<sub>2</sub> Score 0-1 and Taking Warfarin</b>