Risk Stratification and Anticoagulation in Low-risk Non-valvular Atrial Fibrillation

Dear Editor, We thank Dr. Kiani for highlighting again the importance of risk stratification in patients with non- valvular atrial fibrillation (AF). We do agree with him as stated also in our review (see text and Figure 1) that the CHA2DS-2VASc score should be currently applied to patients with CHADS-2Score 2 for further risk stratification as also recommended by current guidelines (1,2). It is noteworthy to mention that The CHA2DS-2VASc score has been validated in numerous AF populations and compared with CHADS-2Score (2). Therefore all patients with CHA2DS-2VASc score of 1 should be considered for stroke prevention, which is essentially treatment with oral anticoagulation agents. The HAS-BLED-Score (range 9-0, high risk 3) for bleeding can further help us to choose the appropriate oral anticoagulation agent in patients with non-valvular-AF (1,2). In patients with a CHADS2 score of 0 but with a high risk of bleeding, apixaban and dabigatran showed a net clinical benefit.