Risk stratification of patients with atrial fibrillation: Biomarkers and other future perspectives

Table 2 Clinical risk stratification scores for patients with atrial fibrillation: pros and cons

In favour

Very simple to understand

Easy to use

Solid evidence supporting the use of these classifications

Patients classified as low risk according to the CHA2DS2-VASc score are truly low risk (annual risk of events 0%)

Against

Limited capability to detect patients at risk of thromboembolism

Patients with a high thromboembolic risk are also bound to present a high bleeding risk

Patients classified as high risk present no additional benefit when treated more aggressively

Individuals classified as low risk with the CHADS2 score are not truly low risk: 19% risk at ten years

According to the CHA2DS2-VASc score, almost all individuals should be placed under oral anticoagulation (only 8.4% of subjects were classified as having a score of 0 in the validation cohort of this score[5]) and, even in the highest risk score, with a CHA2DS2-VASc score of 9, most patients experienced no events after 5 and 10 yr of follow-up