Patient stratification

Decisions about anticoagulation means balancing the benefit of stroke reduction against the risk of haemorrhage using scoring systems.

Before starting anticoagulation, clinicians should use a stratification scheme for stroke and haemorrhage to help balance the risks and benefits.6 The ESC/EHRA guidelines recommend the CHA2DS2-VASc (Table 6 and Figure 18) score to predict stroke risk in AF patients. 

Table 6. CHA2DS2-VASc scoring system for assessing stroke risk.6

CHA2DS2-VASc scoring system for assessing stroke risk

In addition, clinicians should use a bleeding risk stratification scheme, such as HAS-BLED (Table 7 and Figure 18) to assess haemorrhage risk and identify risk factors (Table 8) for major bleeding in people taking anticoagulants. Biomarkers, such as high-sensitivity troponin and natriuretic peptide, can help further assess the risk of stroke and bleeding risk in AF.5

Table 7. HAS-BLED scoring system for assessing haemorrhage risk.5

CHA2DS2-VASc scoring system for assessing stroke risk
Risk of stroke and haemorrhage based on the CHA2DS2-VASc (maximum 9 points) and HAS-BLED (maximum 7 points) scoring system

Figure 18. Risk of stroke and haemorrhage based on the CHA2DS2-VASc (maximum 9 points) and HAS-BLED (maximum 7 points) scoring system.6

Table 8. Risk factors for haemorrhage in patients taking anticoagulants.5,38

CHA2DS2-VASc scoring system for assessing stroke risk

 

The next section features an introduction to anticoagulation therapy


Read more:

Login/ Register Maximise Minimise