The ABC Stroke Risk Score
The ABC (Age, Biomarkers, Clinical history) risk score has been developed to predict the risk of stroke or systemic embolism in patients with atrial fibrillation. The ABC Stroke Risk Score is internally and externally validated using two clinical trial databases.

This model is intended to be used for patients who have been diagnosed with either paroxysmal, persistent or permanent atrial fibrillation or atrial flutter and with at least one or more of the risk factors. The full inclusion criteria are stated in the intended use.
Research authors: Ziad Hijazi, Johan Lindbäck, John H. Alexander, Michael Hanna, Claes Held, Elaine M. Hylek, Renato D. Lopes, Jonas Oldgren, Agneta Siegbahn, Ralph A.H. Stewart, Harvey D. White, Christopher B. Granger, Lars Wallentin, on behalf of the ARISTOTLE and STABILITY investigators
Version: 3.10
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The risk of stroke or systemic embolism is: %

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The current model calculates the risk of a stroke or systemic embolism occurring within the next 1, 2, or 3 years. 

The ABC risk score was externally validated and compared head-to-head with similar prediction models such as the CHA2DS2-VASc score. The external validation of the ABC score resulted in a c-index of 0.66 versus 0.58 for the CHA2DS2-VASc score. 

Multiple guidelines recommed to include anticoagulant treatment based on the CHA2DS2-VASc score. The ESC guideline on the management of atrial fibrillation provides the following recommendations for anticoagulant therapy. 

  • CHA2DS2-VASc score = 0: No antiplatelet or anticoagulant treatment recommended
  • CHA2DS2-VASc score = 1: OAC should be considered
  • CHA2DS2-VASc score ≥ 2: Oral anticoagulation indicated
However, the ABC stroke risk score was compared to the CHA2DS2-VASc score and showed that several patients with a CHA2DS2-VASc score ≥ 2 were at very low risk (<0.3% risk) according to the ABC Stroke Risk Score. In addition, several patients with a CHA2DS2-VASc score of 0 showed to be at high risk (>2% risk) of stroke. 

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