Incidence of Stroke and CHADS2 Score in Patients with Paroxysmal, Persistent or Permanent Atrial Fibrillation: Prognosis at 1 Year of Follow-Up

Objectives: our main endpoints were to determine the incidence of fatal or nonfatal stroke either ischemic or hemorrhagic or transient ischaemic attack, associated with paroxysmal versus persistent and permanent atrial fibrillation (AF), in patients receiving oral anticoagulation therapy (OAC) compared to antiplatelet group, and to test the accuracy of CHADS2 score for the prediction of tromboembolic and hemorrhagic complications, at one year follow up. Secondary endpoints were the hospitalization rate, case fatality at one year and rate of progression of paroxysmal to persistent/permanent AF.
Material and methods: we performed a retrospective (2007–2008) observational study on 468 patients admitted to our department with paroxysmal, persistent and permanent nonvalvular AF, on oral anticoagulation or antiplatelet therapy. We compared the incidence of thromboembolic and hemorrhagic events in patients with paroxysmal AF, persistent and permanent AF, and in patients undergoing anticoagulation versus antiplatelet therapy.
Results: we found a statistically difference between the group of patients treated with OAC and the one treated with antiplatelet therapy in favor for the OAC group of AF in what concerns one year rate of stroke. We also found a statistical difference between the CHADS2 score values and the rate of stroke after during one year.
Conclusions: permanent form of atrial fibrillation carries a higher risk of tromboembolic events than persistent and paroxysmal AF. OAC therapy is superior to platelet therapy in all forms of cardiac arrhythmia in preventing the tromboembolic events. CHADS2 score is a good predictor for stroke.