Risk Stratification, An Indispensible Cogitation to Avert Stroke in Patients with Atrial Fibrillation: Evidence from a Prospective Observational Study from India

Abstract

The comprehensive management of AF aims not only at the restoration of the sinus rhythm but indulges itself in thromboprophylaxis for stroke prevention which remains inevitable. A prospective observational study was carried out. Newly diagnosed and existing cases with AF above the age of 18 years were reviewed for eligibility. Demographic details and complete history of the patients was obtained from medication charts and personal interview with patients and their attendants. This was succeeded by stratification of subjects using stroke risk calculators namely CHADS2 and CHA2DS2-VASc Score. Bleeding risk assessment was performed using HAS-BLED Score. Data from total of 130 patients were collected. At the outset, CHADS2 score was wielded to categorize the subjects based on their risk for stroke as a complication of AF and results revealed that 23% (n=12) were categorized as low risk, followed by 48 (36.92%) patients who were categorized to be intermediate risk. Higher proportion of the patients, i.e. 53.84% (n=70) were categorized to be at a high risk of developing stroke as a complication of AF. The same subjects were categorized for their stroke risk using the second risk stratification scheme, precisely CHA2DS2VASc score. The intermediate risk category comprises of 21.53% (n=28) with high risk category (81.53%, n=106) being the loftiest. CHADS2 score and CHA2DS2VASc score can be easily used to identify the patients at a risk for stroke. The study sketched a comprehensive description of incident AF patients and proffered estimates of the incidence of vascular and other outcomes in patients with AF.