Table 2.

 Recommendations of oral anticoagulants for stroke prevention based on stroke risk and the risk re-assessment

Guidelines	Tipping points and the recommendations for stroke prevention	Statements or recommendations about the risk re-assessment
2017 APHRS	OACs for patients with a score ≥1 (males) or ≥2 (females)	None
2018 ACCP	OACs should be offered for patients with a score ≥1 (males) or ≥2 (females)	Stroke risk is dynamic, and risk should be re-assessed at every patient visit
2019 ACC/AHA/HRS	Class IIb recommendation—OACs for score 1 (males) or 2 (females)   Class I recommendation—OACs for score ≥2 (males) or ≥3 (females)	Re-evaluation of the need for and choice of anticoagulant therapy at periodic intervals is recommended to reassess stroke and bleeding risks
2020 ESC	Class IIa recommendation—OACs for score 1 (males) or 2 (females)   Class I recommendation—OACs for score ≥2 (males) or ≥3 (females)	Class I recommendation—stroke and bleeding risk reassessment at periodic intervals is recommended to inform treatment decisions (e.g. initiation of OAC in patients no longer at low risk of stroke) and address potentially modifiable bleeding risk factors.   Class IIa recommendation—in patients with AF initially at low risk of stroke, first reassessment of stroke risk should be made 4–6 months after the index evaluation.

ACC/AHA/HRS, American College of Cardiology/American Heart Association/Heart Rhythm Society; ACCP, American College of Chest Physicians; APHRS, Asia Pacific Heart Rhythm Society; ESC, European Society of Cardiology; OACs, oral anticoagulants.