TIMI-AF Score of Fanola et al for Predicting Risk of an Adverse Event in a Patient with Atrial Fibrillation

Patient selection: atrial fibrillation with CHADS2 or CHA2DS2-VASc >= 2

Exclusions: creatinine clearance < 30 mL per minute, reversible cause of AF, dual antiplatelet therapy, acute coronary syndrome within past 30 days, acute stroke within 30 days, mitral stenosis, or mechanical valves

Outcome: disabling stroke, life-threatening bleeding, all-cause mortality

Parameters:

(1) age in years

(2) left ventricular function with ejection fraction in percent

(3) hemoglobin in g/dL

(4) race

(5) baseline atrial fibrillation or atrial flutter (associated with sustained or permanent arrhythmia or longer history)

(6) prior ischemic stroke

(7) prior myocardial infarction

(8) serum creatinine in µmol/L

(9) gender

(10) diabetes mellitus

(11) history of carotid artery disease

total score =

= SUM(points for all 11 parameters)

Interpretation:

• minimum score: 0

• maximum score: 17

• The higher the score the greater the risk for an adverse event.

• A non-vitamin K antagonist oral anticoagulant (such as edoxaban) is preferred for a vitamin K antagonist naive patient (<= 60 days of therapy prior to enrollment) with intermediate or high risk.

• A vitamin K antagonist should be used in a patient who is vitamin K experienced or a patient who is vitamin K antagonist naive and low risk.