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Anticoagulant Therapy in Atrial Fibrillation for Stroke Prevention: Assessment of Agreement Between Clinicians’ Decision and CHA2DS2-VASc and HAS-BLED Scores

  • Marzieh Balaghi-Inalou
  • Saeed Alipour Parsa
  • Latif Gachkar
  • Sasan Andalib
Original Article

Abstract

Introduction

To prevent stroke, anticoagulants should be administered after calculation of CHA2DS2-VASc and HAS-BLED scores in patients with Atrial Fibrillation (AF); nonetheless, these scores are sometimes neglected in clinical settings.

Aim

The present study was designed to assess agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores in Iranian AF patients in Moddares Hospital.

Methods

AF patients were diagnosed according to clinical history, clinical examination, and electrocardiogram. Data including the anticoagulant prescription according to clinicians were recorded. CHA2DS2-VASc and HAS-BLED scores were then calculated for each patient. Agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores was analyzed using Cohen’s kappa coefficient.

Results

97.5% of the patients (n = 117) were appropriately (according CHA2DS2-VASc and HAS-BLED scores) treated with anticoagulants by clinicians, notwithstanding a 2.5% of patients with inappropriate anticoagulant therapy (n = 3). The Cohen’s kappa coefficient was 0.81 (P = 0.0).

Conclusions

The findings of the present study suggest an almost perfect agreement between anticoagulant therapy according to clinicians and that according to CHA2DS2-VASc and HAS-BLED scores in the studied population.

Keywords

Atrial fibrillation Clinician decision CHA2DS2-VASc HAS-BLED Agreement assessment 

Notes

Acknowledgements

We thank Shahid Beheshti University of Medical Sciences for its support.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there is no conflict of interest regarding the present study.

Ethical approval

The present study was approved by local ethics committee.

Informed consent

Written informed consent was obtained from each patient.

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Marzieh Balaghi-Inalou
    • 1
  • Saeed Alipour Parsa
    • 1
  • Latif Gachkar
    • 1
  • Sasan Andalib
    • 2
  1. 1.Cardiovascular Research Center, Department of Cardiology, Modarres Hospital, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
  2. 2.Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of MedicineGuilan University of Medical SciencesRashtIran

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