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The recent 2014 American Heart Association, American College of Cardiology, and Heart Rhythm Society guideline for the management of patients with atrial fibrillation (AF) recommends using the CHA2DS2-VASc stroke risk score instead of the older CHADS2 score when deciding whether to recommend anticoagulant therapy, in essence lowering the threshold at which oral anticoagulation is recommended.1 As O’Brien et al2 report, the net effect of using the CHA2DS2-VASc score is to recategorize a large proportion of patients with AF as being at high risk for stroke, thereby making oral anticoagulation recommended for most patients with AF.
Fang MC. Implications of the New Atrial Fibrillation Guideline. JAMA Intern Med. 2015;175(5):850-851. doi:10.1001/jamainternmed.2015.20