{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T22:27:52Z","timestamp":1758925672796,"version":"3.41.2"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,8,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score has been validated for stroke risk prediction in patients with atrial fibrillation (AF). Antithrombotic therapy is not recommended for low\u2010risk patients with AF (CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc 0 [male] or 1 [female]). We studied a cohort of initially low\u2010risk patients with AF in relation to their development of incident comorbidities and their treatment on oral anticoagulation therapy.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We assessed data from 14\u00a0441 low\u2010risk patients with AF (CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score of 0 [male] or 1 [female]) using the Korean National Health Insurance Service database, in relation to their development of incident stroke risk factors and adverse outcomes. The clinical end point was the occurrence of ischemic stroke, major bleeding, all\u2010cause death, or the composite outcome (ischemic stroke + major bleeding + all\u2010cause death). In our cohort, 2615 (29.1%) male and 1650 (30.3%) female patients acquired at least 1 new stroke risk factor during a mean follow\u2010up of 2.0\u00a0years. Among the patients with an increasing CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score \u22651, male and female patients treated with oral anticoagulants had a significantly lower risk of ischemic stroke (male: hazard ratio [HR], 0.62 [95% CI, 0.44\u20130.82;\n              <jats:italic>P<\/jats:italic>\n              =0.003]; female: HR, 0.65 [95% CI, 0.47\u20130.84;\n              <jats:italic>P<\/jats:italic>\n              =0.007]), all\u2010cause death (male: HR, 0.67 [95% CI, 0.49\u20130.88;\n              <jats:italic>P<\/jats:italic>\n              =0.009]; female: HR, 0.82 [95% CI, 0.63\u20131.02;\n              <jats:italic>P<\/jats:italic>\n              =0.185]), and composite outcomes (male: HR, 0.78 [95% CI, 0.61\u20130.95;\n              <jats:italic>P<\/jats:italic>\n              =0.042]; female: HR, 0.79 [95% CI, 0.62\u20130.96;\n              <jats:italic>P<\/jats:italic>\n              =0.045]) than patients not treated with oral anticoagulants.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Approximately 30% of patients acquired \u22651 stroke risk factor over a 2\u2010year follow\u2010up period. Low\u2010risk patients with AF should be regularly reassessed to adequately identify those with incident stroke risk factors that would merit thromboprophylaxis for the prevention of stroke and the composite outcome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016271","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T09:14:49Z","timestamp":1597137289000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Anticoagulant Therapy in Initially Low\u2010Risk Patients With Nonvalvular Atrial Fibrillation Who Develop Risk Factors"],"prefix":"10.1161","volume":"9","author":[{"given":"Sun Young","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"},{"name":"Department of Biomedical Laboratory Science Daegu Health College Daegu Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3468-6453","authenticated-orcid":false,"given":"Moo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Rak","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Sung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dong\u2010A University Hospital Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung\u2010Cheol","family":"Yun","sequence":"additional","affiliation":[{"name":"Departmentof Clinical Epidemiology and Biostatistics University of Ulsan College of Medicine Asan Medical Center Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Chest &amp; Heart Hospital Liverpool United Kingdom"},{"name":"Aalborg Thrombosis Research Unit Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"1230","article-title":"Stroke prevention in atrial fibrillation: past, present and future","author":"Lip GYH","year":"2017","unstructured":"Lip GYH, Freedman B, De Caterina R, Potpara TS. Stroke prevention in atrial fibrillation: past, present and future. 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ACC\/AHA\/ESC 2006 guidelines for the management of patients with atrial fibrillation\u2010executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol. 2006;854\u2013906.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_1_11_2","first-page":"e125","article-title":"2019 AHA\/ACC\/HRS focused update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation","author":"January CT","year":"2019","unstructured":"January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, Ellinor PT, Ezekowitz MD, Field ME, Furie KL, et al. 2019 AHA\/ACC\/HRS focused update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation. 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Thromb Haemost. 2019;1162\u20131170.","journal-title":"Thromb Haemost"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.026"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021047"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz210"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2011.112"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.016271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:56:35Z","timestamp":1715601395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.016271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,18]]},"references-count":16,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2020,8,18]]}},"alternative-id":["10.1161\/JAHA.120.016271"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.016271","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2020,8,18]]},"assertion":[{"value":"2020-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e016271"}}