The various risk stratification schemes classified variable proportions as low , moderate and high risk , but the CHA(2)DS(2)-VASc score classified the smallest proportion of patients as ' low risk ' .
Anticoagulation with vitamin K antagonists and dabigatran is cost-effective in patients at high risk of stroke , but not in patients without any other stroke risk factor beside AF .
A longitudinal population-based study of prothrombotic factors in elderly subjects with atrial fibrillation: the Rotterdam Study 1990-1999.
BACKGROUND A prothrombotic or hypercoagulable state in atrial fibrillation may contribute to stroke and thromboembolism . Results of longitudinal population -based studies in elderly people with atrial fibrillation are not yet available . METHODS In the Rotterdam Study , a population -based prospect i ve cohort study , 162 participants with atrial fibrillation at baseline , aged 55 years and over , were matched for age and gender with 324 people in sinus rhythm . Associations were examined between three coagulation factors and the risk of total and cardiac mortality and stroke . Hazard rate ratios were calculated with 95 % confidence intervals using Cox 's proportional hazards model , adjusted for potential confounders . RESULTS Plasma von Willebr and factor was , age- and gender-adjusted , associated with cardiac mortality in the total population ( relative risk 1.16 ; 1.06 - 1.27 , per 10 IU dL(-1 ) increase ) , but statistical significance was lost after additional adjustments . A strong association ( 1.27 ; 1.08 - 1.50 , per 5-unit increase ) was found between soluble P-selectin ( sP-sel ) and cardiac mortality in atrial fibrillation patients but not in participants in sinus rhythm . Furthermore , the expected association between fibrinogen and cardiac mortality was observed only in those in sinus rhythm ( 2.60 ; 1.69 - 4.01 , per unit increase ) , and not in atrial fibrillation . No associations were found between coagulation factors and stroke . CONCLUSIONS In this population -based study , plasma levels of sP-sel predicted clinical adverse outcomes in atrial fibrillation , suggesting a role of platelets in the prothrombotic state associated with atrial fibrillation . Fibrinogen was a risk factor of cardiac and all-cause mortality in sinus rhythm , but not in atrial fibrillation
The various risk stratification schemes classified variable proportions as low , moderate and high risk , but the CHA(2)DS(2)-VASc score classified the smallest proportion of patients as ' low risk ' .
Anticoagulation with vitamin K antagonists and dabigatran is cost-effective in patients at high risk of stroke , but not in patients without any other stroke risk factor beside AF .