195 SUMMARY patients hospitalised with COVID-19 is impacted by sex and age.7 For this purpose, multivariable logistic regression analyses were used.7 In this study, 5,782 patients were included.7 7.3% of these patients developed new AF and/or atrial flutter (AFL) during hospitalisation. This was associated with a two- to three-fold increased risk of in-hospital mortality in men aged 60-72 years, an effect not observed in women.7 These results improved the identification of subgroups of COVID-19 patients in whom the prognostic impact of new-onset AF and/or AFL on mortality is the most pronounced. STROKE RATE VARIATION AND ANTICOAGULATION BENEFIT IN ATRIAL FIBRILLATION Proper AF management with oral anticoagulation starts with identifying patients who do and who do not benefit from this medication. Most importantly stroke risk reduction should outweigh the increased risk of bleeding. In Chapter 4 a letter to the editor is presented in response to a published article about variation in stroke risk according to the CHA2DS2-VAsc model and anticoagulation benefit in patients with AF. 8 The authors of the published article reported relevant uncertainty regarding the CHA2DS2VASc score threshold above which anticoagulant treatment should be initiated.9 They argued that this uncertainty should receive more attention in AF guidelines.9 In the letter to the editor, the results of a large systematic review and meta-analysis, which reached a similar conclusion, were presented to support the authors’ conclusion. In the meta-analysis, a large heterogeneity was observed in predicted stroke risks, notably for the CHA2DS2-VASc scores 1, 2 and 3 which play an important role in deciding on prescribing anticoagulants.10 TRENDS IN PREVALENCE AND ANTITHROMBOTIC PRESCRIPTIONS IN PATIENTS WITH ATRIAL FIBRILLATION Chapter 5 is a descriptive study on the trends in prevalence of AF and the choices in the prescription of antithrombotic therapy.11 This study used Dutch routine care data from approximately 385,000 patients in the Julius General Practitioners’ Network.11 From 2008 to 2017, 7,459 AF patients were registered.11 During this period, the prevalence of AF more than tripled: from 0.4% to 1.4%.11 This increase is due to the ageing of the population, but also to better awareness, detection and registration of AF. Furthermore, this study showed that in AF patients the prevalence of VKA prescriptions decreased from 47% in 2008 to 41% in 2017, while during the same period the prevalence of NOAC prescriptions increased from 0% to 20%.11 Moreover, it was notable that in 2017, 25% of all AF patients with a CHA2DS2-VASc score ≥2 were still not prescribed a prophylactic oral anticoagulant,11 whereas (also back then) this was recommended in the guidelines.1,12 Multivariable logistic regression analyses were used A
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