Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?

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Click here if you have atrial fibrillation, are age 55 or older, and want to find out your risk of stroke.

This interactive tool measures the chance of having a stroke in the next 5 years, for people who are age 55 or older and have atrial fibrillation. To calculate your score, the tool uses the information you enter.

This tool is based on information from the Framingham Heart Study. Since 1948 the Framingham Heart Study has studied the progression of heart disease and its risk factors. The data from this study has been used to make a risk assessment.

You should be aware, though, that the tool cannot be applied to everyone. This tool does not work for people who:

• Have mitral valve stenosis or significant left ventricular dysfunction, which interferes with the heart's ability to pump well.
• Are already taking the anticoagulant warfarin (such as Coumadin). Warfarin prevents clots from forming and greatly reduces the risk of stroke.
• Have had a stroke or transient ischemic attack within 30 days of developing atrial fibrillation. If so, you are already at high risk, and this tool will not work for you.

The values you enter include the most important risk factors for stroke. They are:

• Age and gender. The risk of stroke increases with age. The risk doubles every decade after age 55. Also, among those with atrial fibrillation, women have a higher risk of stroke than men.
• Systolic blood pressure. Systolic blood pressure is the first number of your blood pressure reading. For example, if your reading is 120/80 (120 over 80), your systolic blood pressure is 120 millimeters of mercury (mm Hg).
• Diabetes. Having diabetes increases your risk of stroke. You can decrease this risk by working with your doctor to keep your blood sugar levels at normal or near-normal levels.
• Prior stroke or transient ischemic attack (TIA). If you have had a stroke or a transient ischemic attack (TIA) within 30 days of developing atrial fibrillation, you are already at high risk, and this tool will not work for you. But if you had a prior stroke or TIA before you developed atrial fibrillation, this tool will work for you.

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	Stroke risk from atrial fibrillation

Your score will appear in as a value from 1% to 99%. If your score is 5%, it means that 5 out of 100 people with this level of risk will have a stroke in the next 5 years. If your score is 10%, it means that 10 out of 100 people with this level of risk will have a stroke in the next 5 years.

These percentages are one way your doctor might determine whether you should take the anticoagulant warfarin (such as Coumadin) to prevent a stroke. Talk with your doctor about the best way to lower your risk of stroke.

If you are at a 10% risk or lower, you may get enough protection from stroke by taking aspirin. Aspirin may be preferred because the risk of serious bleeding from taking warfarin outweighs the risk of having a stroke.

If you are above a 10% risk, talk to your doctor about taking warfarin. You may benefit from this medicine because your risk for having a stroke is greater than the risks from taking warfarin.

Talk to your doctor about how to lower your risk of stroke if you have atrial fibrillation. You may be able to take medicine or make lifestyle changes, such as quitting smoking or changing your diet, that can reduce your chances of stroke. Although warfarin offers the best protection against stroke, it can also cause serious bleeding and other problems. Some people cannot take warfarin because they have ulcers, a high risk of falling, or other conditions that increase the risk of serious bleeding. If you have a moderate to high risk of stroke but cannot take warfarin, your doctor will probably have you take another medicine.

For more information, see the topic Atrial Fibrillation.

This tool was derived from Wang TJ, et al. (2003). A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: The Framingham heart study. JAMA, 290(8): 1049–1056. The Framingham Heart Study is a project of the National Heart, Lung, and Blood Institute, a part of the National Institutes of Health and the U.S. Department of Health and Human Services, and Boston University. More information is available online at www.framinghamheartstudy.org.

Other Works Consulted

• Fuster V, et al. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation—Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation). Circulation, 114(7): 700–752.

• Wang TJ, et al. (2003). A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: The Framingham heart study. JAMA, 290(8): 1049–1056.