Liječnički vjesnik, Vol. 135 No. 3-4, 2013.
Review article
THROMBOEMBOLIC AND BLEEDING RISK ASSESSMENT IN PATIENTS WITH NON-RHEUMATIC ATRIAL FIBRILLATION USING CHA2DS2-VASC AND HAS-BLED SCORING SYSTEMS
Ivona Božić
Ivana Cvitković
Vedran Carević
Krešimir Čaljkušić
Gorana Trgo
Damir Fabijanić
Abstract
It is estimated that approximately 1–2% of the world population are affected with non-rheumatic atrial fibrillation (nAF). The most frequent complications of this arrhythmia are thromboembolic events, primarly ischemic stroke. In comparison with patients in sinus rhythm, stroke affected nAF patients have more severe clinical course and significantly higher mortality rate, and the survivors have significantly lower recovery rate and more serious permanent mental and physical impairments. The administration of anticoagulants to patients with nAF significantly reduces the incidence of stroke, while those who were stroke affected during the anticoagulant therapy show better treatment outcomes. Therefore, professional associations guidelines recommend the anticoagulant treatment for the majority of patients with nAF. The fear of bleeding caused by anticoagulants results in their frequently unjustified omission from the therapy in patients with high thromboembolic risk. This paper presents CHA2DS2-VASc- and HAS-BLED systems recommended for thromboembolic and bleeding risk assessment when deciding on thromboprophylactic therapy in patients with nAF.
Keywords
Atrial fibrillation – complications, drug therapy; Anticoagulants – therapeutic use, adverse effects; Hemorrhage etiology, prevention and control; Thromboembolism – prevention and control; Stroke – prevention and control; Risk assessment – methods
Hrčak ID:
172469
URI
Publication date:
30.4.2013.
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