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Risk of Ischemic Stroke and Stroke Prevention in Patients with Atrial Fibrillation and Renal Dysfunction

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and its prevalence is projected to continuously increase over the next few decades.1 AF patients usually have several important comorbidities, such as hypertension, diabetes and heart failure, and “lone AF” is becoming uncommon.2 The incidence of AF significantly increased when patients have more systemic diseases. In the previous study from Taiwan, the risk of new-onset AF increased from 0.77 per 1000 person-years for patients with a CHADS2 (congestive heart failure, hypertension, age ≥75, diabetes mellitus, and prior stroke or transient ischemic attack) score of 0 to 34.6 per 1000 person-years for those with a score of 6.3 AF is an important risk factor of ischemic stroke with a worse prognosis and higher recurrence rate compared to that of non-AF related stroke.4 The risk of AF-related stroke is not homogenous and mainly depends on the presence or absence of clinical risk factors. Several scoring systems, including CHADS2 and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65–74, female) schemes,5-6 which incorporated clinical important factors have been developed to estimate the risk of stroke and guide anti-thrombotic therapies for AF patients.

Credits: Tze-Fan Chao; Shih-Ann Chen

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Introduction to AFib
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