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Tuesday, September 15, 2009

Risk Stratification for Stroke in Atrial Fibrillation

Understanding a patient's risk for stroke is an important consideration in recommending which type of medication to perscribe to try and prevent a stroke.

Here is some research:

High-Risk Factors:
  • Mitral stenosis
  • Prosthetic heart valve
  • History of stroke or TIA
Moderate-Risk Factors:
  • Age > 75 years
  • Hypertension
  • Diabetes mellitus
  • Heart failure or decrease heart function
Less-Validated Risk Factors:
  • Age 65-75 years
  • Coronary artery disease
  • Female gender
  • Thyrotoxicosis
Dubious Risk Factors:
  • Duration of atrial fibrillation
  • Pattern of atrial fibrillation (paraoxysmal vs persistent)
  • Left atrial diameter
I recommend all patients with atrial fibrialltion discuss their risk factors with their physician and devise a treatment plan based on an evidenced-based data.
Chest. 2004;126:429S
Circulation. 2005; 112:1687

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