Vol 16, No 6 (2021)
Original paper
Published online: 2021-12-15
Does the CHA2DS2-VASc score determine anticoagulant treatment in atrial fibrillation patients? Data from the POLish Atrial Fibrillation (POL-AF) Registry
Folia Cardiologica 2021;16(6):359-368.
Abstract
Introduction. Oral anticoagulants (OAC) should be used in patients with atrial fibrillation (AF) depending on the thromboembolic risk assessed using the CHA2DS2-VASc score. The aim of the study is to verification if the CHA2DS2-VASc score influences using OACs in patients with AF and also to analyse predictors of OAC use in AF patients at non-high (intermediate and low) thromboembolic risk.
Material and methods. The presented study has been based on the data from the POL-AF Registry which is a prospective, multicentre study including patients with diagnosed AF consecutively hospitalized in 10 cardiology centres from January to December 2019.
Results. The study comprised 3,956 patients. A high risk of thromboembolic complications was observed in 91.4%, intermediate in 6.3% and low in 2.3% of them. OACs were administered to 81.1% of patients, including 91.5% at high, 90.3% at intermediate and 86.2% at low thromboembolic risk. CHA2DS2-VASc score was not a predictor of using OACs in all patients with AF [odds ratio (OR) 1.02, confidence interval (CI): 0.96–1.08, p = 0.747]. In the group of patients with non-high thromboembolic risk, the factor predisposing to OAC prescription was hospitalization due to electrical cardioversion [OR 6.55, CI: 1.52–28.21, p = 0,012], contrary to anaemia (OR 0.27, CI: 0.12–0.64, p = 0,003) and cancer (OR 0.14, CI: 0.03–0.57, p = 0.006), which decreased the chance of using OACs in this group.
Conclusions. The CHA2DS2-VASc score was not a predictor of OAC use in the whole study cohort. In the significant proportion of non-high thromboembolic risk patients with AF, OACs were administered, mainly because of temporary indications.
Keywords: oral anticoagulantatrial fibrillationthromboembolic risk
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