New Risk Score Improves Stroke Prediction for Atrial Fibrillation Patients, Possibly Reducing Unnecessary Bleeding Risks
BURLINGTON, VT – A newly developed risk assessment tool promises to considerably improve stroke prediction in patients with atrial fibrillation (AFib), potentially allowing doctors to more precisely tailor anticoagulant treatment and minimize the risk of dangerous bleeding side effects. The research, published recently in the journal of Thrombosis and Haemostasis, integrates standard blood test results with the existing CHA2DS2-VASC score, a widely used system for evaluating stroke risk.
Atrial fibrillation, a common heart rhythm disorder, dramatically increases the risk of stroke. Anticoagulant medications are frequently enough prescribed to mitigate this risk, but they carry a significant risk of serious bleeding complications. Determining who truly needs these medications – and at what dosage – has been a long-standing challenge for clinicians.Currently, doctors rely on the CHA2DS2-VASC score, which considers factors like age, sex, and existing medical conditions like high blood pressure and diabetes. While helpful, this score doesn’t account for crucial biological indicators detectable through routine blood tests. These indicators can reveal underlying heart problems, heightened coagulation tendencies, or inflammation – all factors that can influence stroke risk.
Researchers at the University of Vermont’s Cardiovascular and Cerebral Health Center and Larner College of Medicine have addressed this gap with the “Cha2Ds2-Vasc-Biomarkers” score. This improved tool incorporates data from nine common blood tests, identifying proteins linked to cardiac issues, rapid blood clotting, and inflammation.
The development of the new score is based on analysis of data from two studies. The first, utilizing data from the national Regards study following over 30,000 adults, analyzed blood tests from 713 AFib patients already on anticoagulants. Over 12 years, 9% still experienced a stroke, and researchers found three specific blood tests were significantly correlated with this outcome.
The second study examined data from 2,400 AFib patients not currently on anticoagulants. Over 13 years,7% suffered a stroke. Two of the same blood tests proved useful in refining the CHA2DS2-VASC score, leading to the creation of the Cha2Ds2-Vasc-Biomarkers system.
“We offer doctors a more precise tool to be able to adapt the anticoagulant treatment to the real needs of each patient and to avoid unnecessary risks. It can transform how we prevent a stroke,” explained Dr. Mary Cushman, lead researcher, in a statement.
The research was supported by the National institutes of Health (NIH). Initial findings were presented at the American Heart Association conference in 2024.
The Cha2Ds2-Vasc-Biomarkers risk calculator is now available online for clinicians at http://www.uvm.edu/chadsvascb. This development represents a significant step forward in personalized medicine for atrial fibrillation, offering the potential to optimize treatment strategies and improve patient outcomes.
