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Stroke Risk Stratif...
Stroke Risk Stratification in Patients With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting.
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- Taha, Amar, 1978 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Nielsen, Susanne, 1969 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Franzén, Stefan, 1967 (author)
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Rezk, Mary (author)
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- Ahlsson, Anders (author)
- Karolinska Institutet
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Friberg, Leif (author)
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Björck, S. (author)
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- Jeppsson, Anders, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Bergfeldt, Lennart, 1950 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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(creator_code:org_t)
- 2022
- 2022
- English.
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In: Journal of the American Heart Association. - 2047-9980. ; 11:10
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Background The CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75years, diabetes, previous stroke or TIA [transient ischemic attack], vascular disease, age 65 to 74years, sex category female; 2 indicates 2 points, otherwise 1 point) scoring system is recommended to guide decisions on oral anticoagulation therapy for stroke prevention in patients with nonsurgery atrial fibrillation. A score ≥1 in men and ≥2 in women, corresponding to an annual stroke risk exceeding 1%, warrants long-term oral anticoagulation provided the bleeding risk is acceptable. However, in patients with new-onset postoperative atrial fibrillation, the optimal risk stratification method is unknown. The aim of this study was therefore to evaluate the CHA2DS2-VASc scoring system for estimating the 1-year ischemic stroke risk in patients with new-onset postoperative atrial fibrillation after coronary artery bypass grafting. Methods and Results All patients with new-onset postoperative atrial fibrillation and without oral anticoagulation after first-time isolated coronary artery bypass grafting performed in Sweden during 2007 to 2017 were eligible for this registry-based observational cohort study. The 1-year ischemic stroke rate at each step of the CHA2DS2-VASc score was estimated using a Kaplan-Meier estimator. Of the 6368 patients included (mean age, 69.9years; 81% men), >97% were treated with antiplatelet drugs. There were 147 ischemic strokes during the first year of follow-up. The ischemic stroke rate at 1year was 0.3%, 0.7%, and 1.5% in patients with CHA2DS2-VASc scores of 1, 2, and 3, respectively, and ≥2.3% in patients with a score ≥4. A sensitivity analysis, with the inclusion of patients on anticoagulants, was performed and supported the primary results. Conclusions Patients with new-onset atrial fibrillation after coronary artery bypass grafting and a CHA2DS2-VASc score <3 have such a low 1-year risk for ischemic stroke that oral anticoagulation therapy should probably be avoided.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Aged
- Anticoagulants
- therapeutic use
- Atrial Fibrillation
- complications
- diagnosis
- epidemiology
- Coronary Artery Bypass
- adverse effects
- Female
- Humans
- Ischemic Attack
- Transient
- Ischemic Stroke
- Male
- Risk Assessment
- Risk Factors
- Stroke
- epidemiology
- etiology
- prevention & control
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Taha, Amar, 1978
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Nielsen, Susanne ...
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Franzén, Stefan, ...
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Rezk, Mary
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Ahlsson, Anders
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Friberg, Leif
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show more...
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Björck, S.
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Jeppsson, Anders ...
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Bergfeldt, Lenna ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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University of Gothenburg
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Karolinska Institutet