{"id":"d4ddb2b626d0","type":"article","url":"https://hartvaat.nl/2021/10/09/klinische-risicofactoren-voor-cva-bij-anticoagulantie-naieve-af-meta-analyse/","title":"Klinische risicofactoren voor CVA bij anticoagulantie-naïeve AF: meta-analyse","title_en":"A meta-analysis of clinical risk factors for stroke in anticoagulant-naïve patients with atrial fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["abelacimab","anticoagulantia","anticoagulatie-kwetsbare-ouderen","rivaroxaban"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euab087","source_url":"https://doi.org/10.1093/europace/euab087","authors":["Jean Jacques Noubiap","Vitalis Fambombi Feteh","Melissa E Middeldorp","John L Fitzgerald","Gijo Thomas","Timothy Kleinig","Dennis H Lau","Prashanthan Sanders"],"significance":6,"published":"2021-10-09","source_date":"2021-10-09","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/"],"congress":"","summary_en":"This meta-analysis of clinical risk factors for stroke in anticoagulant-naive AF patients identified the strongest predictors of thromboembolism, informing risk stratification for anticoagulation initiation decisions.","created":"2026-07-03T10:29:26Z","updated":"2026-07-03T13:28:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse van klinische risicofactoren voor beroerte bij anticoagulantie-naïeve AF-patiënten.","abstract_original":"AIMS: The aim of this study is to summarize data from prospective cohort studies on clinical predictors of stroke and systemic embolism in anticoagulant-naïve atrial fibrillation (AF) patients. METHODS AND RESULTS: EMBASE, MEDLINE, Global Index Medicus, and Web of Science were searched to identify all studies published by 28 November 2019. Forty-seven studies reporting data from 1 756 984 participants in 15 countries were included. The pooled incidence of stroke in anticoagulant-naïve AF patients was 23.8 per 1000 person-years (95% CI 19.7-28.2). Older age was associated with incident stroke or systemic embolism, with a pooled hazard ratio (HR) of 2.14 (95% CI 1.85-2.47), 2.83 (95% CI 2.27-3.51), and 6.87 (95% CI 6.33-7.44) for age 65-75, ≥75, and ≥85 years, respectively. Other predictors of stroke or systemic embolism included history of stroke or TIA (HR 2.84, 95% CI 2.19-3.67), hypertension (HR 1.60, 95% CI 1.37-1.86), diabetes (HR 1.28, 95% CI 1.20-1.37), heart failure (HR 1.25, 95% CI 1.11-1.40), peripheral artery disease (pooled HR 1.35, 95% CI 1.04-1.75), vascular disease (pooled HR 1.21, 95% CI 1.06-1.39), and prior myocardial infarction (pooled HR 1.08, 95% CI 1.03-1.14). Female sex was a predictor of thromboembolism in studies outside Asia (HR 1.35, 95% CI 1.15-1.59), but not in those done in Asia (HR 0.95, 95% CI 0.81-1.10). CONCLUSION: This study confirms age and prior stroke as the strongest predictors of stroke or systemic embolism in anticoagulant-naive AF patients. Other predictors include hypertension, diabetes, heart failure, and vascular disease. Female sex seems not to be universally associated with stroke or systemic embolism."}