Letter by Asinger et al Regarding Articles, “Should Patients With Atrial Fibrillation and 1 Stroke Risk Factor (CHA2DS2-VASc Score 1 in Men, 2 in Women) Be Anticoagulated? Yes: Even 1 Stroke Risk Factor Confers a Real Risk of Stroke” and “Should Patients With Atrial Fibrillation and 1 Stroke Risk Factor (CHA2DS2-VASc Score 1 in Men, 2 in Women) Be Anticoagulated?: The CHA2DS2-VASc 1 Conundrum: Decision Making at the Lower End of the Risk Spectrum”
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To the Editor:
Stroke risk stratification schemes for nonvalvular atrial fibrillation (NVAF) and major bleeds with long-term oral anticoagulation (OAc) provide guidance to providers charged with recommending OAc.1 CHA2DS2-VASc scores of 0 for men and 1 for women identify such a low stroke risk that OAc risk outweighs benefit, whereas CHA2DS2-VASc scores ≥2 for men and ≥3 for women establish OAc eligibility.1 These criteria were based primarily on event rates from placebo or ineffective aspirin-dosed patients from original randomized controlled trials of warfarin. …