Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia.
College of Medicine and Public Health, Flinders University of South Australia, Bedford Park, South Australia 5042, Australia.
Europace. 2021 May 21;23(5):665-673. doi: 10.1093/europace/euaa287.
Atrial fibrillation (AF) is an established independent risk factor for stroke. Current guidelines regard AF as binary; either present or absent, with the decision for anti-coagulation driven by clinical variables alone. However, there are increasing data to support a biological gradient of AF burden and stroke risk, both in clinical and non-clinical AF phenotypes. As such, this raises the concept of combining AF burden assessment with a clinical risk score to refine and individualize the assessment of stroke risk in AF-the CHA2DS2VASc-AFBurden score. We review the published data supporting a biological gradient to try and construct a putative schema of risk attributable to AF burden.
心房颤动（AF）是中风的既定独立危险因素。目前的指南将 AF 视为二元的；要么存在，要么不存在，抗凝治疗的决定仅取决于临床变量。然而，越来越多的数据支持 AF 负荷和中风风险的生物学梯度，包括临床和非临床 AF 表型。因此，这提出了将 AF 负荷评估与临床风险评分相结合的概念，以细化和个体化 AF 中的中风风险评估——CHA2DS2VASc-AFBurden 评分。我们回顾了支持生物学梯度的已发表数据，试图构建一个归因于 AF 负荷的风险推测性方案。
