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Next frontier is inclusion of high-grade carotid artery stenosis in the CHA2DS2 Vasc score
  1. Oscar Jolobe
  1. Manchester Medical Society, Manchester, UK
  1. Correspondence to Dr Oscar Jolobe, Manchester Medical Society, Manchester M13 9PL, UK; oscarjolobe{at}

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To the Editor A corollary to the recommendation for anticoagulant persistence1 is a recognition that the time is long overdue for inclusion of evaluation of the extracranial carotid artery for evidence of high-grade (ie >50% occlusion) carotid artery stenosis (CAS). The following is the rationale for the latter recommendation:

Among patients aged >70, high-grade CAS has a prevalence of 12% among men and 11% among women.2

A …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Author note Identification of the coexistence of high-grade carotid artery stenosis and atrial fibrillation generates an opportunity to implement measures that might mitigate the risk of subsequent occurrence of disabling stroke.

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