Adherence to treatment guidelines: the association between stroke risk stratified comparing CHADS and CHADS-VASc score levels and warfarin prescription for adult patients with atrial fibrillation.

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BMC health services research, ISSN: 1472-6963, Vol: 17, Issue: 1, Page: 127

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Chapman, Scott A; St Hill, Catherine A; Little, Meg M; Swanoski, Michael T; Scheiner, Shellina R; Ware, Kenric B; Lutfiyya, M Nawal
Springer Nature
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article description
Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS, and more recently the CHADS-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy. Warfarin, for stroke prevention in AF, is the most commonly prescribed anticoagulant in North America. The purpose of this study was to examine the utility of using the CHADS score levels (low and high) in contrast to the CHADS-VASc when examining the outcome of warfarin prescriptions for adult patients with AF. The CHADS-VASc tool was not widely used in 2010, when the data analyzed were collected. It has only been since 2014 that CHADS-VASc criteria has been recommended to guide anticoagulant treatment in updated AF treatment guidelines.