Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1
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22 novembre 2017
- handle: 10670/1.e7m4sn
- hal: hal-03679500
- doi: 10.1160/TH09-10-0746
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info:eu-repo/semantics/altIdentifier/doi/10.1160/TH09-10-0746
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Laurent Gorin et al., « Antithrombotic treatment and the risk of death and stroke in patients with atrial fibrillation and a CHADS2 score=1 », HALSHS : archive ouverte en Sciences de l’Homme et de la Société, ID : 10.1160/TH09-10-0746
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Summary In patients with atrial fibrillation (AF) and an intermediate risk of stroke (CHADS2 score =1), available evidence from clinical trials is inconclusive and the present guidelines for the management of AF indicate that the choice between oral anticoagulant and aspirin in these patients is open. Our goal was to evaluate whether, in patients with AF and only one moderate risk factor for thromboembolism, treatment with an oral anticoagulant is appreciably more beneficial than treatment with an antiplatelet agent. Among 6,517 unselected patients with AF, 1,012 of them (15.5%) had a CHADS2 score of 1 and were liable to treatment with an antiplatelet agent or an anticoagulant. An oral anticoagulant was prescribed for 606 patients (59.9%) and an antiplatelet agent or no antithrombotic treatment for 406 (40.1%). During follow-up (median=793 days, interquartile range=1,332 days), 105 deaths (10.4%) and 19 strokes (1.9%) were recorded. The administration of an anticoagulant was associated with a lower rate of events (relative risk=0.42, 95% confidence interval 0.29–0.60, p