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For physicians, one of the principal challenges will be what to do with patients who are perceived to be at low risk. In the initial presentation in this session Dr Reiffel presented a summary of the differences between the CHADS2 and the CHA2DS2-VASc scoring systems. As discussed then, although patients with a CHADS2 score of 0 to 1 may seem be a low-risk group, there are subsets of these patients who are actually at higher risk of a stroke. The CHA2DS2-VASc scoring system enables physicians to more accurately stage these patients and may enable discovery that these patients’ stroke risk is actually double that indicated by a CHADS2 score of 0 to 1.[63] [64]
Rothman SA. Am J Med 2013; 126: 00-00.
[63] Olesen JB, Torp-Pedersen C, Hansen ML, Lip GY. The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study. Thromb Haemost. 2012;107:1172-1179.
[64] Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864-2870.