The annual stroke risk for Taiwanese patients ages 50 to 64 may exceed the threshold for anticoagulant use in stroke prevention, according to the results of a study published Sept. 14 in the Journal of the American College of Cardiology.

Using data from the National Health Insurance Research Database in Taiwan, researchers evaluated the risk of ischemic stroke in 9,416 males with a CHA₂DS₂-VASc score of 0 and 6,390 females with a CHA₂DS₂-VASc score of 1. Participants in both groups were non-anticoagulated atrial fibrillation (AFib) patients.

The results of the study showed that patients could be divided into two different subgroups with different annual stroke risks: patients greater than 50 years of age had an annual stroke risk of 1.78 percent while those under 50 years old had an annual stroke risk of 0.53 percent. Further, the annual risks of stroke for male and female AFib patients between the ages of 50 and 54 were 1.47 percent and 1.07 percent, respectively.

The authors of the study note that “resetting the age threshold at 50 years may [help] to further identify truly low-risk patients with AFib among males with a CHA₂DS₂-VASc score of 0 and females with a CHA₂DS₂-VASc score of 1.”

“It is important to bear in mind, though, that optimum treatment cannot be determined without prospective studies,” state John A. Savino III, MD, and Jonathan L. Halperin, MD, FACC, in an accompanying editorial comment. “We should also be cautious in extrapolating the findings to other Asian population. And, although ethnicity seems pertinent, a host of clinical factors must be considered in the decision to employ long-term anticoagulation…”

Listen to an audio commentary by Valentin Fuster, MD, PhD, MACC .

Keywords: Anticoagulants, Atrial Fibrillation, Ethnic Groups, National Health Programs, Stroke, Taiwan

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