Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study

M. Paciaroni, G. Agnelli, V. Caso, G. Tsivgoulis, K.L. Furie, P. Tadi, C. Becattini, N. Falocci, M. Zedde, A.H. Abdul-Rahim, K.R. Lees, A. Alberti, M. Venti, M. Acciarresi, C. D'Amore, M.G. Mosconi, L.A. Cimini, A. Procopio, P. Bovi, M. CarlettiA. Rigatelli, M. Cappellari, J. Putaala, L. Tomppo, T. Tatlisumak, F. Bandini, S. Marcheselli, A. Pezzini, L. Poli, A. Padovani, L. Masotti, V. Vannucchi, S.-I. Sohn, G. Lorenzini, R. Tassi, F. Guideri, M. Acampa, G. Martini, G. Ntaios, E. Karagkiozi, G. Athanasakis, K. Makaritsis, K. Vadikolias, C. Liantinioti, S. Sacco, A. Carolei, G. Colombo, M. Mancuso, M. Maccarrone, A. Chiti

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95% confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95% confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. © 2017 American Heart Association, Inc.
Original languageEnglish
Pages (from-to)726-732
Number of pages7
JournalStroke
Volume48
Issue number3
DOIs
Publication statusPublished - 2017

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Atrial Fibrillation
Stroke
Hemorrhage
Confidence Intervals
ROC Curve
Area Under Curve
Logistic Models
Transient Ischemic Attack
Embolism

Keywords

  • atrial fibrillation
  • myocardial infarction
  • risk stratification
  • stroke
  • anticoagulant agent
  • warfarin
  • aged
  • anticoagulant therapy
  • Article
  • cardiovascular risk
  • cerebrovascular accident
  • computer assisted tomography
  • early diagnosis
  • early intervention
  • female
  • heart atrium enlargement
  • human
  • major clinical study
  • male
  • nuclear magnetic resonance
  • observational study
  • outcome assessment
  • priority journal
  • prospective study
  • recurrence risk
  • risk assessment
  • thromboembolism
  • transient ischemic attack
  • transthoracic echocardiography
  • bleeding
  • chemically induced
  • complication
  • Ischemic Attack, Transient
  • procedures
  • recurrent disease
  • Stroke
  • very elderly
  • Aged
  • Aged, 80 and over
  • Anticoagulants
  • Atrial Fibrillation
  • Female
  • Hemorrhage
  • Humans
  • Male
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Thromboembolism
  • Warfarin

Cite this

Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study. / Paciaroni, M.; Agnelli, G.; Caso, V.; Tsivgoulis, G.; Furie, K.L.; Tadi, P.; Becattini, C.; Falocci, N.; Zedde, M.; Abdul-Rahim, A.H.; Lees, K.R.; Alberti, A.; Venti, M.; Acciarresi, M.; D'Amore, C.; Mosconi, M.G.; Cimini, L.A.; Procopio, A.; Bovi, P.; Carletti, M.; Rigatelli, A.; Cappellari, M.; Putaala, J.; Tomppo, L.; Tatlisumak, T.; Bandini, F.; Marcheselli, S.; Pezzini, A.; Poli, L.; Padovani, A.; Masotti, L.; Vannucchi, V.; Sohn, S.-I.; Lorenzini, G.; Tassi, R.; Guideri, F.; Acampa, M.; Martini, G.; Ntaios, G.; Karagkiozi, E.; Athanasakis, G.; Makaritsis, K.; Vadikolias, K.; Liantinioti, C.; Sacco, S.; Carolei, A.; Colombo, G.; Mancuso, M.; Maccarrone, M.; Chiti, A.

In: Stroke, Vol. 48, No. 3, 2017, p. 726-732.

Research output: Contribution to journalArticle

Paciaroni, M, Agnelli, G, Caso, V, Tsivgoulis, G, Furie, KL, Tadi, P, Becattini, C, Falocci, N, Zedde, M, Abdul-Rahim, AH, Lees, KR, Alberti, A, Venti, M, Acciarresi, M, D'Amore, C, Mosconi, MG, Cimini, LA, Procopio, A, Bovi, P, Carletti, M, Rigatelli, A, Cappellari, M, Putaala, J, Tomppo, L, Tatlisumak, T, Bandini, F, Marcheselli, S, Pezzini, A, Poli, L, Padovani, A, Masotti, L, Vannucchi, V, Sohn, S-I, Lorenzini, G, Tassi, R, Guideri, F, Acampa, M, Martini, G, Ntaios, G, Karagkiozi, E, Athanasakis, G, Makaritsis, K, Vadikolias, K, Liantinioti, C, Sacco, S, Carolei, A, Colombo, G, Mancuso, M, Maccarrone, M & Chiti, A 2017, 'Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study', Stroke, vol. 48, no. 3, pp. 726-732. https://doi.org/10.1161/STROKEAHA.116.015770
Paciaroni, M. ; Agnelli, G. ; Caso, V. ; Tsivgoulis, G. ; Furie, K.L. ; Tadi, P. ; Becattini, C. ; Falocci, N. ; Zedde, M. ; Abdul-Rahim, A.H. ; Lees, K.R. ; Alberti, A. ; Venti, M. ; Acciarresi, M. ; D'Amore, C. ; Mosconi, M.G. ; Cimini, L.A. ; Procopio, A. ; Bovi, P. ; Carletti, M. ; Rigatelli, A. ; Cappellari, M. ; Putaala, J. ; Tomppo, L. ; Tatlisumak, T. ; Bandini, F. ; Marcheselli, S. ; Pezzini, A. ; Poli, L. ; Padovani, A. ; Masotti, L. ; Vannucchi, V. ; Sohn, S.-I. ; Lorenzini, G. ; Tassi, R. ; Guideri, F. ; Acampa, M. ; Martini, G. ; Ntaios, G. ; Karagkiozi, E. ; Athanasakis, G. ; Makaritsis, K. ; Vadikolias, K. ; Liantinioti, C. ; Sacco, S. ; Carolei, A. ; Colombo, G. ; Mancuso, M. ; Maccarrone, M. ; Chiti, A. / Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study. In: Stroke. 2017 ; Vol. 48, No. 3. pp. 726-732.
@article{5a3f586c5307411981e75548968c06e9,
title = "Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study",
abstract = "Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95{\%} confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95{\%} confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95{\%} confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. {\circledC} 2017 American Heart Association, Inc.",
keywords = "atrial fibrillation, myocardial infarction, risk stratification, stroke, anticoagulant agent, warfarin, aged, anticoagulant therapy, Article, cardiovascular risk, cerebrovascular accident, computer assisted tomography, early diagnosis, early intervention, female, heart atrium enlargement, human, major clinical study, male, nuclear magnetic resonance, observational study, outcome assessment, priority journal, prospective study, recurrence risk, risk assessment, thromboembolism, transient ischemic attack, transthoracic echocardiography, bleeding, chemically induced, complication, Ischemic Attack, Transient, procedures, recurrent disease, Stroke, very elderly, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Female, Hemorrhage, Humans, Male, Prospective Studies, Recurrence, Risk Assessment, Thromboembolism, Warfarin",
author = "M. Paciaroni and G. Agnelli and V. Caso and G. Tsivgoulis and K.L. Furie and P. Tadi and C. Becattini and N. Falocci and M. Zedde and A.H. Abdul-Rahim and K.R. Lees and A. Alberti and M. Venti and M. Acciarresi and C. D'Amore and M.G. Mosconi and L.A. Cimini and A. Procopio and P. Bovi and M. Carletti and A. Rigatelli and M. Cappellari and J. Putaala and L. Tomppo and T. Tatlisumak and F. Bandini and S. Marcheselli and A. Pezzini and L. Poli and A. Padovani and L. Masotti and V. Vannucchi and S.-I. Sohn and G. Lorenzini and R. Tassi and F. Guideri and M. Acampa and G. Martini and G. Ntaios and E. Karagkiozi and G. Athanasakis and K. Makaritsis and K. Vadikolias and C. Liantinioti and S. Sacco and A. Carolei and G. Colombo and M. Mancuso and M. Maccarrone and A. Chiti",
note = "Cited By :1 Export Date: 2 March 2018 CODEN: SJCCA Correspondence Address: Paciaroni, M.; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Via G. Dottori 1, Italy; email: maurizio.paciaroni@unipg.it Chemicals/CAS: warfarin, 129-06-6, 2610-86-8, 3324-63-8, 5543-58-8, 81-81-2; Anticoagulants; Warfarin References: Paciaroni, M., Agnelli, G., Falocci, N., Caso, V., Becattini, C., Marcheselli, S., Early recurrence and cerebral bleeding in patients with acute ischemic stroke and atrial fibrillation: Effect of anticoagulation and its timing: The RAF study (2015) Stroke, 46, pp. 2175-2182; Paciaroni, M., Agnelli, G., Falocci, N., Caso, V., Becattini, C., Marcheselli, S., Prognostic value of trans-thoracic echocardiography in patients with acute stroke and atrial fibrillation: Findings from the RAF study (2016) J Neurol., 263, pp. 231-237; Lang, R.M., Bierig, M., Devereux, R.B., Flachskampf, F.A., Foster, E., Pellikka, P.A., Recommendations for chamber quantification: A report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group developed in conjunction with the European Association of Echocardiography a branch of the European Society of Cardiology (2005) J Am Soc Echocardiogr., 18, pp. 1440-1463. , Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography; Fischer, U., Arnold, M., Nedeltchev, K., Brekenfeld, C., Ballinari, P., Remonda, L., NIHSS score and arteriographic findings in acute ischemic stroke (2005) Stroke, 36, pp. 2121-2125; Schulman, S., Kearon, C., Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients (2005) J Thromb Haemost., 3, pp. 692-694. , Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis; Strbian, D., Meretoja, A., Ahlhelm, F.J., Pitk{\"a}niemi, J., Lyrer, P., Kaste, M., Predicting outcome of IV thrombolysis-treated ischemic stroke patients: The DRAGON score (2012) Neurology., 78, pp. 427-432; Micheli, S., Agnelli, G., Caso, V., Paciaroni, M., Clinical benefit of early anticoagulation in cardioembolic stroke (2008) Cerebrovasc Dis., 25, pp. 289-296; Paciaroni, M., Agnelli, G., Ageno, W., Caso, V., Timing of anticoagulation therapy in patients with acute ischaemic stroke and atrial fibrillation (2016) Thromb Haemost., 116, pp. 410-416; Lip, G.Y., Nieuwlaat, R., Pisters, R., Lane, D.A., Crijns, H.J., Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The euro heart survey on atrial fibrillation (2010) Chest., 137, pp. 263-272",
year = "2017",
doi = "10.1161/STROKEAHA.116.015770",
language = "English",
volume = "48",
pages = "726--732",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study

AU - Paciaroni, M.

AU - Agnelli, G.

AU - Caso, V.

AU - Tsivgoulis, G.

AU - Furie, K.L.

AU - Tadi, P.

AU - Becattini, C.

AU - Falocci, N.

AU - Zedde, M.

AU - Abdul-Rahim, A.H.

AU - Lees, K.R.

AU - Alberti, A.

AU - Venti, M.

AU - Acciarresi, M.

AU - D'Amore, C.

AU - Mosconi, M.G.

AU - Cimini, L.A.

AU - Procopio, A.

AU - Bovi, P.

AU - Carletti, M.

AU - Rigatelli, A.

AU - Cappellari, M.

AU - Putaala, J.

AU - Tomppo, L.

AU - Tatlisumak, T.

AU - Bandini, F.

AU - Marcheselli, S.

AU - Pezzini, A.

AU - Poli, L.

AU - Padovani, A.

AU - Masotti, L.

AU - Vannucchi, V.

AU - Sohn, S.-I.

AU - Lorenzini, G.

AU - Tassi, R.

AU - Guideri, F.

AU - Acampa, M.

AU - Martini, G.

AU - Ntaios, G.

AU - Karagkiozi, E.

AU - Athanasakis, G.

AU - Makaritsis, K.

AU - Vadikolias, K.

AU - Liantinioti, C.

AU - Sacco, S.

AU - Carolei, A.

AU - Colombo, G.

AU - Mancuso, M.

AU - Maccarrone, M.

AU - Chiti, A.

N1 - Cited By :1 Export Date: 2 March 2018 CODEN: SJCCA Correspondence Address: Paciaroni, M.; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Via G. Dottori 1, Italy; email: maurizio.paciaroni@unipg.it Chemicals/CAS: warfarin, 129-06-6, 2610-86-8, 3324-63-8, 5543-58-8, 81-81-2; Anticoagulants; Warfarin References: Paciaroni, M., Agnelli, G., Falocci, N., Caso, V., Becattini, C., Marcheselli, S., Early recurrence and cerebral bleeding in patients with acute ischemic stroke and atrial fibrillation: Effect of anticoagulation and its timing: The RAF study (2015) Stroke, 46, pp. 2175-2182; Paciaroni, M., Agnelli, G., Falocci, N., Caso, V., Becattini, C., Marcheselli, S., Prognostic value of trans-thoracic echocardiography in patients with acute stroke and atrial fibrillation: Findings from the RAF study (2016) J Neurol., 263, pp. 231-237; Lang, R.M., Bierig, M., Devereux, R.B., Flachskampf, F.A., Foster, E., Pellikka, P.A., Recommendations for chamber quantification: A report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group developed in conjunction with the European Association of Echocardiography a branch of the European Society of Cardiology (2005) J Am Soc Echocardiogr., 18, pp. 1440-1463. , Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography; Fischer, U., Arnold, M., Nedeltchev, K., Brekenfeld, C., Ballinari, P., Remonda, L., NIHSS score and arteriographic findings in acute ischemic stroke (2005) Stroke, 36, pp. 2121-2125; Schulman, S., Kearon, C., Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients (2005) J Thromb Haemost., 3, pp. 692-694. , Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis; Strbian, D., Meretoja, A., Ahlhelm, F.J., Pitkäniemi, J., Lyrer, P., Kaste, M., Predicting outcome of IV thrombolysis-treated ischemic stroke patients: The DRAGON score (2012) Neurology., 78, pp. 427-432; Micheli, S., Agnelli, G., Caso, V., Paciaroni, M., Clinical benefit of early anticoagulation in cardioembolic stroke (2008) Cerebrovasc Dis., 25, pp. 289-296; Paciaroni, M., Agnelli, G., Ageno, W., Caso, V., Timing of anticoagulation therapy in patients with acute ischaemic stroke and atrial fibrillation (2016) Thromb Haemost., 116, pp. 410-416; Lip, G.Y., Nieuwlaat, R., Pisters, R., Lane, D.A., Crijns, H.J., Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The euro heart survey on atrial fibrillation (2010) Chest., 137, pp. 263-272

PY - 2017

Y1 - 2017

N2 - Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95% confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95% confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. © 2017 American Heart Association, Inc.

AB - Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95% confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95% confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. © 2017 American Heart Association, Inc.

KW - atrial fibrillation

KW - myocardial infarction

KW - risk stratification

KW - stroke

KW - anticoagulant agent

KW - warfarin

KW - aged

KW - anticoagulant therapy

KW - Article

KW - cardiovascular risk

KW - cerebrovascular accident

KW - computer assisted tomography

KW - early diagnosis

KW - early intervention

KW - female

KW - heart atrium enlargement

KW - human

KW - major clinical study

KW - male

KW - nuclear magnetic resonance

KW - observational study

KW - outcome assessment

KW - priority journal

KW - prospective study

KW - recurrence risk

KW - risk assessment

KW - thromboembolism

KW - transient ischemic attack

KW - transthoracic echocardiography

KW - bleeding

KW - chemically induced

KW - complication

KW - Ischemic Attack, Transient

KW - procedures

KW - recurrent disease

KW - Stroke

KW - very elderly

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants

KW - Atrial Fibrillation

KW - Female

KW - Hemorrhage

KW - Humans

KW - Male

KW - Prospective Studies

KW - Recurrence

KW - Risk Assessment

KW - Thromboembolism

KW - Warfarin

U2 - 10.1161/STROKEAHA.116.015770

DO - 10.1161/STROKEAHA.116.015770

M3 - Article

VL - 48

SP - 726

EP - 732

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 3

ER -