Stroke and Bleeding Risk Assessment in Atrial Fibrillation: Where Are We Now?

Abstract

Author's summary Stroke prevention with oral anticoagulants (OACs) is the cornerstone for the management of patients with atrial fibrillation (AF). It is crucial to assess the stroke and bleeding risks of individual AF patients to make appropriate decisions for OAC use and achieve optimal patient care. In this review, we provided an overview on the correct use of CHA 2 DS 2 -VASc and HAS-BLED scores, and update important revisions about the definitions of some of the CHA 2 DS 2 -VASc components. Also, data about the biomarkers and potential roles of AF duration and left atrial functions in the prediction of stroke in AF were also discussed.

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

“…Since the risk of stroke of each CHA 2 DS 2 -VASc risk component was not the same and age is an important driver, patients' ages and the comorbidities which contribute to the score 1 for males or 2 for females could be considered when making management decisions about the use of OACs or not 20 42 43 44 45 46 as summarized in Fig. 9 .…”

2021 Focused update of the 2017 consensus guidelines of the Asia Pacific Heart Rhythm Society (APHRS) on stroke prevention in atrial fibrillation

“… 65 Because the risk of stroke of each CHA 2 DS 2 ‐VASc risk component was not the same and age is an important driver, patients’ ages and the comorbidities, which contribute to the score 1 for males or 2 for females could be considered when making management decisions about the use of OACs or not. 43 , 66 , 67 , 68 , 69 as summarized in Figure 11 . As OAC is being started, bleeding risk assessment is recommended, using the HAS‐BLED score to identify and mitigate modifiable bleeding risks, and to identify high bleeding risk patients for early review and follow‐up.…”

Machine Learning for Predicting Atrial Fibrillation Recurrence After Cardioversion: A Modest Leap Forward

“…Atrial fibrillation (AF) is a common cardiac arrhythmia that poses significant challenges in terms of management and treatment. 1) 2) Electrical cardioversion (ECV) is a widely used procedure to restore normal heart rhythm in patients with persistent AF. 3) 4) However, the recurrence of AF after ECV remains a persistent issue, and predicting which patients are at higher risk for recurrence has been a subject of ongoing research.…”