CHADS₂ risk score and rate of stroke or systemic embolism and major bleeding in patients with non-valvular atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants

Abstract

Randomized trials showed non-inferior or superior results of the non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin in patients with non-valvular atrial fibrillation (AF). Despite the absence of direct head-to-head comparisons between the different NOACs, certain molecules have been proposed for subgroups of patients based mainly on the perception of different bleeding risks. The CHADS₂ score has been uniformly used in the inclusion criteria of these studies and shared similar risk factors as the haemorrhagic risk score HAS-BLED. The aim of the present report was to highlight the relationships between CHADS₂ score and the rate of stroke or systemic embolism, and the rate of major bleeding in patients with AF on treatment with NOACs. Overall, in all the available randomized studies, a fairly good continuous relationship was observed between the CHADS₂ risk score and the rate of stroke or systemic embolism, and the rate of major bleeding in the different studies. Larger registries are needed to confirm this hypothesis.

Keywords::

• Atrial fibrillation
• CHADS2 score
• NOACs
• stroke
• major bleeding

CONFLICT OF INTEREST

none.