Predicting Stroke Risk in Patients With Atrial Fibrillation

See related article, pages 2459–2463. Predicting which patients with atrial fibrillation will have a stroke or systemic embolic event is not an easy task. In this issue of Stroke , Lawrence Baruch and colleagues retrospectively compared 7 risk stratification schemes in a large clinical trial–based program of patients with atrial fibrillation (the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation [SPORTIF] III and IV studies).1 As assessed by the concordance (or C ) statistic, which measures the area under a test’s receiver-operating characteristic curve, all prediction schemes performed rather modestly, with the best C statistic belonging to the CHADS2 scheme ( C =0.65).At first glance, these data might suggest caution regarding the use of formal risk stratification schemes to predict stroke in …