Atrial fibrillation and CHA2DS2VASc score of 1 - is there a problem in clinical practice?
E. I. Baranova,
V. A. Pavlova,
V. A. Ionin,
E. Yu. Petrischeva,
O. I. Bliznuk,
E. L. Zaslavskaya,
I. Ma,
D. S. Skuridin,
E. V. Shlakhto https://doi.org/10.15829/1560-4071-2020-3-3738
Abstract
Aim. To study the incidence of nonvalvular atrial fibrillation (AF) in patients with a CHA2DS2VASc score of 1 in actual clinical practice, to determine the major and minor risk factors of thromboembolism and the frequency of oral anticoagulant therapy in these patients.
Material and methods. We performed a retrospective analysis of 6575 medical records of patients hospitalized for five years in a therapeutic inpatient unit. To determine the stroke risk, major and minor modifying factors were assessed.
Results. Of 1160 patients with nonvalvular AF, 93 (8,0%) patients had a CHA2DS2VASc score of 1: hypertension (87,1%), heart failure (4,3%), vascular diseases (4,3%), diabetes (2,15%) and age 65-74 years (2,2%); minor modifying factors were as follows: left atrial (LA) dilatation (81,7%), obesity (40,9%), persistent/permanent AF (37,6%), proteinuria (26,9%), chronic kidney disease (3,2%). A combination of minor risk factors was observed in 61,3%, the most common of which were obesity, LA dilatation, persistent/permanent AF. Anticoagulants were prescribed to 72% of patients with a CHA2DS2VASc score of 1.
Conclusion. In actual clinical practice, patients with nonvalvular AF with a CHA2DS2VASc score of 1 are often found. The most common risk factors for stroke in these patients are hypertension, persistent or permanent AF, LA dilatation, and obesity. The use of anticoagulant therapy in these patients does not contradict current guidelines. However, further prospective follow-up is necessary to determine the effectiveness and safety of this therapy.
Supporting agencies: The study was supported by a grant from the Russian Science Foundation No. 17-75-30052.
About the Authors
E. I. Baranova
Almazov National Medical Research Center;
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Baranova Elena I.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
V. A. Pavlova
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Pavlova Viktoria A.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
V. A. Ionin
Almazov National Medical Research Center;
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Ionin Valery A.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
E. Yu. Petrischeva
Almazov National Medical Research Center
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Petrishcheva Elena Yu.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
O. I. Bliznuk
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Bliznyuk Olga I.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
E. L. Zaslavskaya
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Zaslavskaya Ekaterina L.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
I. Ma
Almazov National Medical Research Center
Russian Federation
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
D. S. Skuridin
First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Skuridin Daniil S.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
E. V. Shlakhto
Almazov National Medical Research Center; First Pavlov State Medical University of St. Petersburg
Russian Federation
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
Russian Federation
Shlyakhto Evgeniy V.
St. Petersburg
Competing Interests: All authors declare that there is no conflict of interest requiring disclosure in this article.
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Review
For citations:
Baranova E.I., Pavlova V.A., Ionin V.A., Petrischeva E.Yu., Bliznuk O.I., Zaslavskaya E.L., Ma I., Skuridin D.S., Shlakhto E.V. Atrial fibrillation and CHA2DS2VASc score of 1 - is there a problem in clinical practice? Russian Journal of Cardiology. 2020;25(3):3738. https://doi.org/10.15829/1560-4071-2020-3-3738
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