Patients with atrial fibrillation and CHA₂DS₂-VASc score 1: "to anticoagulate or not to anticoagulate? That is the question!"

There is uncertainty regarding the optimal therapy for preventing thromboembolic stroke in patients with atrial fibrillation and CHA₂DS₂-VASc score 1. In fact, no extensive data on this topic are available, and the latest guidelines provide different recommendations. In this article, we examine current results on the use of various antithrombotic agents, including the newer oral anticoagulant agents, in those patients. Several factors must be considered and weighted in this setting and may influence the choice of the antithrombotic approach: the expected incidence of both thromboembolic stroke and bleeding complications as well as their impact in terms of morbidity and mortality, the patient's bleeding risk profile, an accurate, further stratification of the thromboembolic risk beyond the CHA₂DS₂-VASc score, and socioeconomic issues.