In a large primary care data set, the CHA₂DS₂-VASc score leads to an almost universal recommendation for anticoagulation treatment in those aged ≥65 years with atrial fibrillation

Orchard, Jessica J.; Giskes, Katrina; Orchard, John W.; La Gerche, Andre; Neubeck, Lis; Hespe, Charlotte; Lowres, Nicole; Freedman, Ben

Abstract

From 2012 to 2016, the oral anticoagulant (OAC) treatment determination for atrial fibrillation (AF) patients moved from the CHADS2 score to the CHA2DS2-VASc score. A data set collated during previous studies (2011–19) with de-identified data extracted from clinical records at a single timepoint for active adult patients (n = 285 635; 8294 with AF) attending 164 general practices in Australia was analysed. The CHA2DS2-VASc threshold (score ≥2 men/≥3 women) captured a significantly higher proportion than CHADS2≥2 (all ages: 85 vs. 68%, P < 0.0001; ≥65 years: 96 vs. 76%, P < 0.0001). The change from CHADS2 to CHA2DS2-VASc resulted in a significantly higher proportion of AF patients being recommended OAC, driven by the revised scoring for age.

Citation

Orchard, J. J., Giskes, K., Orchard, J. W., La Gerche, A., Neubeck, L., Hespe, C., …Freedman, B. (in press). In a large primary care data set, the CHA₂DS₂-VASc score leads to an almost universal recommendation for anticoagulation treatment in those aged ≥65 years with atrial fibrillation. European Journal of Cardiovascular Nursing, https://doi.org/10.1093/eurjcn/zvad002

• Journal Article Type: Article
• Acceptance Date: Dec 31, 2022
• Online Publication Date: Jan 3, 2023
• Deposit Date: Jan 9, 2023
• Publicly Available Date: Jan 9, 2023
• Journal: European Journal of Cardiovascular Nursing
• Print ISSN: 1474-5151
• Electronic ISSN: 1873-1953
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1093/eurjcn/zvad002
• Keywords: stroke prevention, general practice, atrial fibrillation
• Public URL: http://researchrepository.napier.ac.uk/Output/2998025