Stroke and Systemic Thromboembolism according to CHA(2)DS(2)-VASc Score in Contemporary Korean Patients with Atrial Fibrillation
- Authors
- Lee, Kyung Bae; Kim, Tae-Hoon; Park, Junbeom; Park, Jin-Kyu; Kang, Ki-Woon; Kim, Jun; Park, Hyung Wook; Choi, Eue-Keun; Kim, Jin-Bae; Lee, Young Soo; Shim, Jaemin; Joung, Boyoung
- Issue Date
- Apr-2022
- Publisher
- 연세대학교의과대학
- Keywords
- Atrial fibrillation; stroke; embolism; risk
- Citation
- Yonsei Medical Journal, v.63, no.4, pp 317 - 324
- Pages
- 8
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Yonsei Medical Journal
- Volume
- 63
- Number
- 4
- Start Page
- 317
- End Page
- 324
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55598
- DOI
- 10.3349/ymj.2022.63.4.317
- ISSN
- 0513-5796
1976-2437
- Abstract
- Purpose
The incidence of stroke and/or systemic thromboembolism (SSE) has not been properly evaluated in well-anticoagulated atrial fibrillation (AF) patients. This study investigated the incidence of SSE according to CHA2DS2-VASc score in contemporary well-anticoagulated Korean AF patients.
Materials and Methods
From the prospective multicenter COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry, we identified 9503 patients with non-valvular AF (mean age, 68±8 years; female 35.5%) enrolled between June 2016 and May 2020 with eligible follow-up visits. Stroke incidence in the CODE-AF registry was compared with that in an oral anticoagulant (OAC)-naïve AF cohort from the Korean National Health Insurance database.
Results
The usage rates of OACs and antiplatelet agents were 73.5% (non-vitamin K OACs, 56.4%; warfarin, 17.1%) and 23.8%, respectively. During a mean follow-up period of 26.3±9.6 months, 163 (0.78 per 100 person-years) patients had SSE. The incidence rate (per 100 person-years) of SSE was 0.77 in the total population, 0.26 in low-risk patients [CHA2DS2-VASc score 0 (male) or 1 (female)], and 0.88 in high-risk patients (CHA2DS2-VASc score ≥2). Contemporary AF patients had a stroke rate that was about one-fifth the stroke rate reported in a Korean OAC-naïve AF cohort. In this cohort, most risk factors for CHA2DS2-VASc score showed significant associations with SSE. Female sex was not associated with an increased risk of stroke/SSE in well-anticoagulated AF patients.
Conclusion
Contemporary AF patients have a stroke rate about one-fifth that in OAC-naïve AF patients and exhibit different stroke risk factors.
Study Registration
ClinicalTrials.gov (NCT02786095).
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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