Anticoagulant / USA

I have been reading a lot lately about when NOACs are needed.

Please can anyone tell me if there is an equivalent to the Chadsvasc scoring system in America?

It seems the preference for NOACs is 75 years in the states whereas in Europe it's 65. I would like to clarify whether this is the case and if so what is the thinking behind this different age criteria.

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  • According to Wikipedia:

    "AOG may refer to:

    Age of gestation, in the practice of obstetrics

    Aircraft on ground, an aviation term

    Act of God, a legal term for events outside of human control

    Anshan Teng'ao Airport, IATA code AOG

    Army of God (disambiguation), a group of anti-abortion Christian militants

    Assemblies of God, the largest Pentecostal Christian denomination

    Army of God (Bonekickers), the first episode of the BBC Bonekickers Drama

    Gasoline Tanker, US Navy ship types code

    Abscisate beta-glucosyltransferase, an enzyme

    Association of Graduates for the United States Military Academy"

    Does it mean any of these things?

  • CHA2DS2-VASc

    To complement the CHADS2 score, by the inclusion of additional 'stroke risk modifier' risk factors, the CHA2DS2-VASc-score has been proposed.

    In clinical use, the CHADS2 score has been superseded by the CHA2DS2-VASc score that gives a better stratification of low-risk patients. The CHADS2 score has been outperformed by the CHA2DS2-VASc in multiple patient groups including patients with AF who are receiving outpatient elective electrical cardioversion.

    ConditionPoints

    C Congestive heart failure (or Left ventricular systolic dysfunction)1

    H Hypertension: blood pressure consistently above 140/90 mmHg (or treated hypertension on medication)1

    A2 Age ≥75 years 2

    D Diabetes Mellitus 1

    S2 Prior Stroke or TIA or thromboembolism2

    V Vascular disease 1

    A Age 65–74 years1

    Sc Sex category (i.e. female sex)1

    Thus, the CHA2DS2-VASc[7][8][9] score is a refinement of CHADS2[10][11] score and extends the latter by including additional common stroke risk factors, that is, age 65-74, female gender and vascular disease. In the CHA2DS2-VASc score, 'age 75 and above' also has extra weight, with 2 points.

  • I am in US, my EP uses this score. While 65 yrs. of age counts as one point, my EP counts it for me even though I am a little younger, because he says, "What is magically going to change the minute you turn 65 yrs.?" I also have a point for being female and one for diabetes, even though it is very well controlled. Total = 3 points = stay on anti-coagulant.

  • Really like your EP. That is the approach of both GP and EP. You may have seen me state this before about no point at 364 days but 1 at 365 days!!!

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