CHA2DS2-VASc score and initiated anticoagulant treatment in patients with newly diagnosed atrial fibrillation
| Variable | Intervention arm | Control arm | |
|---|---|---|---|
| Screen-detected AF, N= 28 | Regularly detected AF, N= 95 | Regularly detected AF, N= 117 | |
| Mean CHA2DS2-VASc scorea (SD) | 3.6 (1.6) | 4.0 (1.5) | 3.9 (1.5) |
| CHA2DS2-VASc score 1, n (%) | 3 (10.7) | 6 (6.3) | 3 (2.6) |
| Female, n (%) | 15 (53.6) | 51 (53.7) | 71 (60.7) |
| CHA2DS2-VASc score 2 in females, n (%) | 0 (0.0) | 4 (7.8) | 8 (11.3) |
| Initiation of anticoagulant treatment,b n (%) | |||
| VKA | 18 (64.3) | 45 (47.4) | 68 (58.1) |
| NOAC | 5 (17.9) | 41 (43.2) | 34 (29.1) |
| Antiplatelet | 0 (0.0) | 1 (1.1) | 4c (3.4) |
| Details about anticoagulant treatment, n (%) | |||
| According to guidelinesd | 26 (92.9) | 89 (93.7) | 106 (90.6) |
| Intended deviation from guidelinese | 1 (3.6) | 4 (4.2) | 5 (4.3) |
| Unintended deviation from guidelinesf | 1 (3.6) | 2 (2.1) | 6 (5.1) |
↵a CHA2DS2-VASc = Congestive heart failure (1 point); Hypertension (1 point); Age >75 years (2 points); Diabetes mellitus (1 point); Stroke including ischaemic stroke or transient ischaemic attack (2 points); Vascular disease including myocardial infarction, angina pectoris, coronary intervention, peripheral artery disease, arterial, or venous thrombosis (1 point); Age 65–75 years (1 point).
↵b Initiation of oral anticoagulant (OAC) treatment: some patients used OAC before diagnoses for mechanical heart valve or venous thromboembolism (VTE) (either lifelong prescription due to multiple VTE or temporary for recent first VTE); this was 2 for AF detection by screening, 4 for detection in usual care of intervention arm, and 4 for detection in control arm.
↵c Including two cases in whom either fragmin or clopidogrel was initiated.
↵d Treatment according to the Dutch College of General Practitioners guideline for patients treated in primary care and the European Society of Cardiologists guideline for patients treated in hospital.6,7
↵e Documented reason for deviation.
↵f No documented reason for deviation from guidelines. AF = atrial fibrillation. NOAC = novel oral anticoagulants. SD = standard deviation. VKA = vitamin K antagonists.