Fine Tuning Risk Stratification for Atrial Fibrillation

JACC: June 4, 2013

Most clinicians would like to be able to accurately estimate the risk of adverse outcomes, especially if this information could guide management or treatment decisions to lower the risk for an individual. In the case of atrial fibrillation (AF), the most common cardiac arrhythmia, more accurate prediction of its most feared and disabling complication—stroke—remains a major focus (1,). This issue is pertinent as AF is increasing in prevalence and will affect 1 in 4 men and 1 in 6 women during their lifetime (3,4,5,6,7,8). Hospitalization for AF is also increasing, with >360,000 admissions annually in the United States for a first AF episode and >2 million admissions for any listing of AF (9,10,11,12). AF causes 15% of all strokes and is also associated with a 50% increase in mortality for men and a near doubling of mortality for women compared with matched subjects without AF (12,13,14,15).

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