An editorial by Jennifer Wright, MD, clinical assistant professor (pictured at upper right) and Craig January, MD, PhD (pictured at lower right) commented on research about the use of blood thinners for people with atrial fibrillation, which is a common type of heart arrhythmia.

The study, which was conducted by investigators at the University of California-San Francisco, calls into question the optimal score for congestive heart failure, hypertension, age, diabetes, stroke and vascular disease (referred to as CHA₂DS₂-VASc score) that should be used for starting anticoagulation medication in patients with atrial fibrillation.

The editorial by Dr. Wright and Dr. January was published in Annals of Internal Medicine and summarized in Healio Cardiology.

Clinical guidelines currently recommend anticoagulation drugs for patients with a CHA₂DS₂-VASc score of 2 or higher, but the analysis of data from four different clinical studies showed considerable variation in the optimal score threshold for anticoagulation among each of the studies.

"[This report] shows that the CHA2DS2-VASc score threshold for anticoagulation may be not a “one-size fits-all” approach but rather a starting point for a more tailored assessment," wrote Dr. Wright and Dr. January.

Resources:

• "Benefit of anticoagulation for atrial fibrillation varies across patient populations," Healio Cardiology, September 24, 2018
• Wright JM, January CT. 2018. Atrial Fibrillation and Anticoagulation: One Size Fits All? Annals Internal Med. 169(8):575-576

Photo (top): lead placement for an electrocardiogram. Public domain image courtesy of US Army Medical Department.