{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:26:02Z","timestamp":1767907562868,"version":"3.49.0"},"reference-count":66,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T00:00:00Z","timestamp":1458604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The main priority in atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>) management is stroke prevention, following which decisions about rate or rhythm control are focused on the patient, being primarily for management of symptoms. Given that <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> is commonly associated with various comorbidities, risk factors such as hypertension, heart failure, diabetes mellitus and sleep apnoea should be actively looked for and managed in a holistic approach to <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> management. The objective of this review is to provide an overview of modern <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> stroke prevention with a focus on tailored treatment strategies. Biomarkers and genetic factors have been proposed to help identify \u2018high\u2010risk\u2019 patients to be targeted for oral anticoagulation, but ultimately their use must be balanced against that of more simple and practical considerations for everyday use. Current guidelines have directed focus on initial identification of \u2018truly low\u2010risk\u2019 patients with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>, that is those patients with a <jats:styled-content style=\"fixed-case\">CHA<\/jats:styled-content><jats:sub>2<\/jats:sub><jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content><jats:sub>2<\/jats:sub>\u2010<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>c [congestive heart failure, hypertension, age \u226575\u00a0years (two points), diabetes mellitus, stroke (two points), vascular disease, age 65\u201374\u00a0years, sex category] score of 0 (male) or 1 (female), who do not need any antithrombotic therapy. Subsequently, patients with \u22651 stroke risk factors can be offered effective stroke prevention, that is oral anticoagulation. The <jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>e\u2010<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content><jats:sub>2<\/jats:sub>R<jats:sub>2<\/jats:sub> [sex female, age &lt;60\u00a0years, medical history (&gt;2 comorbidities), treatment (interacting drugs), tobacco use (two points), race non\u2010Caucasian (two points)] score can help physicians make informed decisions on those patients likely to do well on warfarin (<jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>e\u2010<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content><jats:sub>2<\/jats:sub>R<jats:sub>2<\/jats:sub> score 0\u20132) or those who are likely to have a poor time in therapeutic range (<jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>e\u2010<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content><jats:sub>2<\/jats:sub>R<jats:sub>2<\/jats:sub> score &gt;2). A clinically focused tailored approach to assessment and stroke prevention in <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> with the use of the <jats:styled-content style=\"fixed-case\">CHA<\/jats:styled-content><jats:sub>2<\/jats:sub><jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content><jats:sub>2<\/jats:sub><jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>c, <jats:styled-content style=\"fixed-case\">HAS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BLED<\/jats:styled-content> [hypertension, abnormal renal\/liver function (one or two points), stroke, bleeding history or predisposition, labile international normalized ratio, elderly (&gt;65\u00a0years) drugs\/alcohol concomitantly (one or two points)] and <jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>e<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content><jats:sub>2<\/jats:sub>R<jats:sub>2<\/jats:sub> scores to evaluate stroke risk, bleeding risk and likelihood of successful warfarin therapy, respectively, is discussed.<\/jats:p>","DOI":"10.1111\/joim.12468","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T12:15:05Z","timestamp":1458648905000},"page":"467-476","source":"Crossref","is-referenced-by-count":17,"title":["A tailored treatment strategy: a modern approach for stroke prevention in patients with atrial fibrillation"],"prefix":"10.1111","volume":"279","author":[{"given":"G. Y. H.","family":"Lip","sequence":"first","affiliation":[{"name":"University of Birmingham Institute of Cardiovascular Sciences Birmingham UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Potpara","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, Clinical Centre of Serbia, School of Medicine University of Belgrade Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Boriani","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, S.Orsola\u2010Malpighi University Hospital Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Blomstr\u00f6m\u2010Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institution of Medical Science Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,22]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq350"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.07.234"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH4-04-0383"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-02-0165"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta9400"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.126656"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014343"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-03-0231"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)70027-X"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70310-7"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007763"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-03-0175"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-03-0228"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-06-0443"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-12-1032"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-09-0741"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus305"},{"key":"e_1_2_4_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000040"},{"key":"e_1_2_4_22_1","unstructured":"National\u2010Institute\u2010for\u2010Health\u2010and\u2010Care\u2010Excellence. Atrial fibrillation: the management of atrial fibrillation. (Clinical guideline 180.) 2014.http:\/\/guidance.nice.org.uk\/CG180. 2014:http:\/\/guidance.nice.org.uk\/CG180."},{"key":"e_1_2_4_23_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_4_24_1","doi-asserted-by":"publisher","DOI":"10.14503\/THIJ-14-4353"},{"key":"e_1_2_4_25_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH11-10-0690"},{"key":"e_1_2_4_26_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_2_4_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04378.x"},{"key":"e_1_2_4_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.972869"},{"key":"e_1_2_4_29_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-14-0584"},{"key":"e_1_2_4_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12360"},{"key":"e_1_2_4_31_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-03-0210"},{"key":"e_1_2_4_32_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-02-0154"},{"key":"e_1_2_4_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.10.052"},{"key":"e_1_2_4_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.11.046"},{"key":"e_1_2_4_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.01.044"},{"key":"e_1_2_4_36_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15\u20101622"},{"key":"e_1_2_4_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.044"},{"key":"e_1_2_4_38_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-07-0565"},{"key":"e_1_2_4_39_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0054"},{"key":"e_1_2_4_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074037"},{"key":"e_1_2_4_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvv012"},{"key":"e_1_2_4_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv088"},{"key":"e_1_2_4_43_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-10-0859"},{"key":"e_1_2_4_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.05.036"},{"key":"e_1_2_4_45_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2976"},{"key":"e_1_2_4_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.05.023"},{"key":"e_1_2_4_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.11.182"},{"key":"e_1_2_4_48_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-11-0948"},{"key":"e_1_2_4_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv202"},{"key":"e_1_2_4_50_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2103"},{"key":"e_1_2_4_51_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105594"},{"key":"e_1_2_4_52_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-01-0054"},{"key":"e_1_2_4_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.035"},{"key":"e_1_2_4_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs435"},{"key":"e_1_2_4_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074248414565666"},{"key":"e_1_2_4_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311386"},{"key":"e_1_2_4_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61994-2"},{"key":"e_1_2_4_58_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv190"},{"key":"e_1_2_4_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus027"},{"key":"e_1_2_4_60_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006426"},{"key":"e_1_2_4_61_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut241"},{"key":"e_1_2_4_62_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.977546"},{"key":"e_1_2_4_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.062"},{"key":"e_1_2_4_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu367"},{"key":"e_1_2_4_65_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302946"},{"key":"e_1_2_4_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu298"},{"key":"e_1_2_4_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv233"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjoim.12468","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjoim.12468","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.12468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T07:33:47Z","timestamp":1696232027000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joim.12468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,22]]},"references-count":66,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1111\/joim.12468"],"URL":"https:\/\/doi.org\/10.1111\/joim.12468","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,22]]}}}