Stroke & Bleeding risk assessment Part 1

What are the learning outcomes of this lecture? (2 points)

. Understand that there is a link between atrial fibrillation (AF) and stroke risk

2. Appreciate that interventions exist to reduce the risk of stroke in patients with AF

What is the association between AF and stroke? (7 points)

1. AF is a leading cause of ischaemic strokes

2. Approximately 20% of all strokes in the UK are due to AF

3. Stroke is often the first presentation of AF

4. AF is associated with more severe strokes and longer TIAs

5. AF is an independent risk factor for embolic stroke

6. Actual risk depends on factors like age, gender, and comorbidities

7. AF prevalence is ~3% in adults and increases with age and comorbidity

What pharmacological interventions reduce stroke risk in AF patients? (4 points)

1. Anticoagulation is the most effective strategy

2. Includes vitamin K antagonists (e.g., warfarin)

3. Includes direct oral anticoagulants (DOACs)

4. Antiplatelets are no longer recommended for this purpose

What is the clinical consideration when using anticoagulants in AF patients? (2 points)

1. Anticoagulants increase the risk of major bleeding events

2. Benefits of stroke prevention must be weighed against bleeding risk

What tools are used for stroke and bleeding risk assessment in AF? (2 points)

1. CHA2DS2-VASc score is used to assess stroke risk

2. ORBIT score is used to assess bleeding risk