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- Title
Stroke and Systemic Thromboembolism according to CHA<sub>2</sub>DS<sub>2</sub>-VASc Score in Contemporary Korean Patients with Atrial Fibrillation.
- Authors
Kyung Bae Lee; Tae-Hoon Kim; Junbeom Park; Jin-Kyu Park; Ki-Woon Kang; Jun Kim; Hyung Wook Park; Eue-Keun Choi; Jin-Bae Kim; Young Soo Lee; Jaemin Shim; Boyoung Joung
- 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.
- Subjects
ATRIAL fibrillation; KOREANS; CEREBRAL embolism &; thrombosis; THROMBOEMBOLISM; DISEASE risk factors; NATIONAL health insurance
- Publication
Yonsei Medical Journal, 2022, Vol 63, Issue 4, p317
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2022.63.4.317