Adding blood tests to existing calculators helps doctors more accurately identify which atrial fibrillation patients need stroke prevention medication, research has shown.
Researchers at the University of Vermont developed an improved tool by incorporating blood test results that detect proteins associated with heart dysfunction, blood clotting and inflammation. These biological markers provide a more precise assessment of stroke risk.
Atrial fibrillation – an irregular heart rhythm – affects around 10.5 million people in the US and is a leading cause of stroke.
Anticoagulants are commonly prescribed to reduce stroke risk, but some patients still experience breakthrough strokes, and the medications carry a risk of dangerous bleeding.
Clinicians currently use the CHA2DS2-VASc score, which estimates stroke risk based on age, sex and medical history.
However, it does not account for biological factors that blood tests can reveal.
Principal investigator Dr Mary Cushman, university distinguished professor of medicine and pathology & laboratory medicine, said: “This could be a game-changer for stroke prevention.
“We’re giving physicians a sharper tool to provide a personalised approach to anticoagulation for patients who need it most, while sparing others from unnecessary risk.”
The updated scoring tool, known as the CHA2DS2-VASc-Biomarkers score, was developed using findings from two studies led by researchers at the Vermont Center for Cardiovascular and Brain Health and the Department of Medicine at the Larner College of Medicine.
In the first study, the team evaluated nine blood tests in 713 people taking anticoagulants to prevent stroke. Over a 12-year follow-up, 9 per cent experienced a breakthrough stroke.
Three tests – linked to heart strain, clotting, and inflammation – were found to predict stroke risk.
In the second study, the same nine blood tests were assessed in 2,400 people not taking anticoagulants. Over 13 years, 7 per cent had strokes. Two of the blood tests improved the predictive power of the CHA2DS2-VASc score.
These two biomarkers were used to create the revised scoring system, which helps doctors determine which patients with atrial fibrillation are most likely to benefit from anticoagulant treatment.
Lead author Dr Samuel Short said: “This will help doctors better select patients for anticoagulation, potentially saving lives and reducing health care costs.”
Now a haematology fellow at the University of North Carolina Chapel Hill, Dr Short began the research as a medical student at the Larner College of Medicine, under the mentorship of Dr Cushman.
