Screening for atrial fibrillation: the role of CHA2DS2-VASc and atrial fibrillation burden.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-07-31 eCollection Date: 2024-07-01 DOI:10.1093/eurheartjsupp/suae078
Lucas Yixi Xing, Oliver B Vad, Daniel Engler, Jesper H Svendsen, Søren Z Diederichsen
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Abstract

Individuals with subclinical atrial fibrillation (AF) face an increased risk of thromboembolic events, which may potentially be mitigated through AF screening and subsequent anticoagulation. However, data from randomized clinical trials (RCTs) indicate a lower stroke risk in subclinical AF compared with the clinical phenotype. This-along with the inherent bleeding risk related to anticoagulation-seems to render the net clinical benefit of AF screening less evident. Further, current guidelines recommend consideration of CHA2DS2-VASc score and AF episode duration to guide screening and treatment. These recommendations, in general, lack support and seem questionable in view of the limited RCT data. More evidence is warranted to provide insights into the potential benefits of screening and treatment of screen-detected AF in specific population subgroups and AF phenotypes.

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心房颤动筛查:CHA2DS2-VASc 和心房颤动负荷的作用。
亚临床心房颤动(房颤)患者发生血栓栓塞事件的风险增加,通过房颤筛查和随后的抗凝治疗有可能减轻这种风险。然而,随机临床试验(RCT)的数据表明,亚临床房颤的中风风险低于临床表型。加上与抗凝相关的固有出血风险,房颤筛查的净临床获益似乎并不明显。此外,目前的指南建议考虑 CHA2DS2-VASc 评分和房颤发作持续时间来指导筛查和治疗。总体而言,这些建议缺乏支持,而且鉴于有限的 RCT 数据,这些建议似乎值得商榷。我们需要更多的证据来揭示筛查和治疗筛查出的房颤对特定人群和房颤表型的潜在益处。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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