ABC-AF Stroke Score

ABC-AF Stroke Score: Age + Biomarkers (NT-proBNP, hsTnT) + Clinical history for AF stroke risk (ESC 2020).

Patient Data & Biomarkers

Age (years)

NT-proBNP (pg/mL)

High-Sensitivity Troponin T (ng/mL)

Clinical History

Prior Stroke or TIA

Vascular Disease (CAD, PAD, Stroke)

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Prognostication of stroke or systemic embolism (SE) in patients with Atrial Fibrillation (AF).

Identification of low-risk patients who may not require oral anticoagulation (OAC).

Refining risk assessment in patients categorized as "intermediate risk" by clinical-only scores.

Endorsed by ESC 2020/2024 guidelines as a preferred tool when biomarkers are available.

Patient Population

Derived from the ARISTOTLE trial (n = 14,701) and externally validated in the STABILITY trial (n = 1,400) and LOOP study (n = 5,781). Includes patients with paroxysmal, persistent, or permanent AF.

When Not to Use

When high-sensitivity troponin or NT-proBNP assays are unavailable.

Valvular AF (mechanical valves/moderate-severe mitral stenosis).

Acute stroke or SE triage — this is a long-term risk stratification tool.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the ABC-AF Bleeding Score, CHA2DS2-VASc, HAS-BLED, ORBIT Score, CHADS2, HEMORR2HAGES, eGFR (CKD-EPI) or the Creatinine Clearance Multi-Method to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

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