Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Apr 12;9(2):113-120.
doi: 10.1080/20009666.2019.1593781. eCollection 2019 Apr.

Stroke risk stratification in atrial fibrillation: a review of common risk factors

Oreoluwa Oladiran  1 , Ifeanyi Nwosu  2
Affiliations
Review

Stroke risk stratification in atrial fibrillation: a review of common risk factors

Oreoluwa Oladiran et al. J Community Hosp Intern Med Perspect. .

Abstract

Atrial Fibrillation (AF) has become a major global health concern being the most common sustained arrhythmia in clinical practice. Risk factors for AF include congestive heart failure, hypertension, increasing age and diabetes. Many of these factors also increase the risk for thromboembolism and ischemic stroke in AF patients. Great efforts have been made from the latter part of the 20th century towards developing an ideal stroke risk stratification tool in AF with the aim of reducing the incidence of stroke in AF patients and the limiting unnecessary use of thromboprophylaxis. The thromboembolic risks posed by AF with valvular heart disease are an important subgroup that contributes to a significant proportion of stroke in AF patients globally. We review the evolution of stroke risk stratification and summarize the guidelines for stroke prevention in non-valvular AF as well as AF with valvular heart disease, and the most recent recommendations on stroke prevention in AF patients. Abbreviations: AF: Atrial Fibrillation; ACS: Acute Coronary Syndrome; CAD: Coronary Artery Disease; CCF: Congestive Cardiac Failure; DM: Diabetes Mellitus; EHRA: Evaluated Heartvalves, Rheumatic or Artificial; ICH: Intracranial Hemorrhage; NOACs: Novel Oral Anticoagulants; OAC: Oral Anticoagulants; PAD: Peripheral Arterial Disease ; TIA: Transient Ischemic Attack; VHD: Valvular Heart Disease.

Keywords: Atrial fibrillation; CHA2DS2VASc score; stroke; thromboprophylaxis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Illustrating the atrial fibrillation better care pathway for integrated management of patients with atrial fibrillation [4].
See this image and copyright information in PMC

References

    1. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American college of cardiology/American heart association task force on practice guidelines and the heart rhythm society. Circulation. 2014;130(23):2071–2104. - PubMed
    1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014;129(8):837–847. - PMC - PubMed
    1. Friberg L, Hammar N, Ringh M, et al. Stroke prophylaxis in atrial fibrillation: who gets it and who does not?Report from the stockholm cohort-study on atrial fibrillation (SCAF-study). Eur Heart J. 2006;27(16):1954–1964. - PubMed
    1. Lip GYH.The ABC pathway: an integrated approach to improve AF management. Nat Rev Cardiol. 2017;14(11):627–628. - PubMed
    1. Proietti M, Romiti GF, Olshansky B, et al. Improved outcomes by integrated care of anticoagulated patients with atrial fibrillation using the simple ABC (atrial fibrillation better care) pathway. Am J Med. 2018;131(11):1359–1366. - PubMed

LinkOut - more resources