{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:47Z","timestamp":1791489707309,"version":"4.3.4"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"\n BACKGROUND:<\/jats:title>\n \n Oral anticoagulation is suggested in patients with atrial fibrillation and a CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc score \u22651 (congestive heart failure, hypertension, age \u226575 years, diabetes, stroke, vascular disease, age 65\u201374 years, and sex score). To assess granular differences within CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1, the incidence of arterial thromboembolism according to CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1 subgroups was examined.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n The Danish National Patient Registry and the Danish Prescription Registry were linked on a nationwide level to identify patients with atrial fibrillation from 2000 to 2021 without oral anticoagulation and categorized according to CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc score: CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 0 (male and female subjects); CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1 (hypertension, heart failure, diabetes, vascular disease, and age 65\u201374 years); or CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 2 (age \u226575 years without other risk factors). Female sex was not considered a risk factor in any risk group. The outcome was arterial thromboembolism (ischemic stroke, embolism of extremity, or transient cerebral ischemia). Study groups were compared using Cox regression analysis.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n We included 26\u2009701 patients with a CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 0 score; 22 915 with CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1 (1483 patients with heart failure, 9066 with hypertension, 843 with diabetes, 770 with vascular disease, and 10\u2009753 who were 65 to 74 years of age); and 14\u2009525 patients with CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 2 (\u226575 years of age without other risk factors). With a median of 1 year of observation time, the cumulative incidence of arterial thromboembolism was 0.6% (n=154 [95% CI, 0.6%\u20130.8%]), 1.4% (n=16 [95% CI, 0.8%\u20132.2%]), 1.9% (n=141 [95% CI, 1.6%\u20132.2%]), 1.7% (n=12 [95% CI, 0.9%\u20132.9%]), 2.0% (n=13 [95% CI, 1.1%\u20133.4%]), 2.3% (n=187 [95% CI, 2.0%\u20132.7%]), and 4.4% (n=533 [95% CI, 4.1%\u20134.8%]) for CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 0, heart failure, hypertension, diabetes, vascular disease, age 65 to 74 years (CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1), and age \u226575 years (CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 2), respectively. No statistically significant difference was identified among subgroups of CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1 (\n P<\/jats:italic>\n =0.15 for difference).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n \n For patients with atrial fibrillation, all subgroups of CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1 were associated with lower incidence of arterial thromboembolism compared with age \u226575 years without other risk factors (ie, CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 2) and a higher incidence compared with CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 0. No statistically significant difference was identified between the subgroups of CHA\n 2<\/jats:sub>\n DS\n 2<\/jats:sub>\n -VASc 1. These findings support current recommendations that patients within this intermediate risk group could be identified with a similar risk of arterial thromboembolism.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circulationaha.123.066477","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T05:00:33Z","timestamp":1703739633000},"page":"764-773","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Arterial Thromboembolism in Patients With Atrial Fibrillation and CHA\n 2<\/sub>\n DS\n 2<\/sub>\n -VASc Score 1: A Nationwide Study"],"prefix":"10.1161","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3298-1467","authenticated-orcid":true,"given":"Lauge","family":"\u00d8stergaard","sequence":"first","affiliation":[{"name":"The Heart Center, Rigshospitalet (L.\u00d8., J.K.P., L.S.N., S.L.K., L.K., E.F.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Bjerring","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte Hospital (J.B.O., M.S.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1166-7877","authenticated-orcid":true,"given":"Jeppe Kofoed","family":"Petersen","sequence":"additional","affiliation":[{"name":"The Heart Center, Rigshospitalet (L.\u00d8., J.K.P., L.S.N., S.L.K., L.K., E.F.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8050-502X","authenticated-orcid":true,"given":"Lukas Schak","family":"Nielsen","sequence":"additional","affiliation":[{"name":"The Heart Center, Rigshospitalet (L.\u00d8., J.K.P., L.S.N., S.L.K., L.K., E.F.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9759-7397","authenticated-orcid":true,"given":"S\u00f8ren Lund","family":"Kristensen","sequence":"additional","affiliation":[{"name":"The Heart Center, Rigshospitalet (L.\u00d8., J.K.P., L.S.N., S.L.K., L.K., E.F.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4271-2466","authenticated-orcid":true,"given":"Morten","family":"Schou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte Hospital (J.B.O., M.S.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":true,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"The Heart Center, Rigshospitalet (L.\u00d8., J.K.P., L.S.N., S.L.K., L.K., E.F.), University of Copenhagen, 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Stroke and bleeding risk in Asians with atrial fibrillation. Accessed June 17 2023. https:\/\/www.acc.org\/latest-in-cardiology\/articles\/2016\/03\/14\/07\/27\/stroke-and-bleeding-risk-in-asians-with-atrial-fibrillation"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15282"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.123.066477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:24:20Z","timestamp":1755523460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.123.066477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,3,5]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.123.066477"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.123.066477","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]},"assertion":[{"value":"2023-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}