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Article: The CHADS2 and CHA2DS2–VASc scores predict new occurrence of atrial fibrillation and ischemic stroke

TitleThe CHADS2 and CHA2DS2–VASc scores predict new occurrence of atrial fibrillation and ischemic stroke
Authors
Issue Date2013
PublisherSpringer. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=1383-875X
Citation
Journal of Interventional Cardiac Electrophysiology, 2013, v. 37 n. 1, p. 47-54 How to Cite?
AbstractBackground Early identification of individuals who are at risk of developing atrial fibrillation (AF) and ischemic stroke may enable a closer surveillance and thus prompt initiation of oral anticoagulation for stroke prevention. Objective This study sought to investigate whether congestive heart failure, hypertension, age ≥ 75 years, diabetes, previous stroke (CHADS2) and CHA2DS2–vascular disease, age 65–74 years, sex category (CHA2DS2–VASc) scores can predict new-onset AF and/or ischemic stroke in patients presenting with arrhythmic symptoms. Methods and results We prospectively followed up 528 patients (68.5 ± 10.6 years, male 46.2 %) presented for assessment of arrhythmic symptoms but without any documented arrhythmia, including AF for development of new-onset AF and/or ischemic stroke. Their mean CHADS2 and CHA2DS2–VASc scores on presentation were 1.3 ± 1.3 and 2.3 ± 1.5, respectively. After 6.1 years, 89 patients (16.8 %, 2.77 per 100 patient-years) had documented AF, and 65 patients (12.3 %, 2.0 per 100 patient-years) suffered stroke. Both the CHADS2 (C statistic 0.63, 95 % confidence interval (CI) 0.58–0.67, P < 0.0001, optimal cutoff at 1) and CHA2DS2–VASc (C statistic 0.63, 95 % CI 0.59–0.67, P < 0.0001, optimal cutoff at 2) scores provided similar prediction for the new-onset AF. Similarly, CHADS2 (C statistic 0.69, 95 % CI 0.65–0.73, P < 0.0001, optimal cutoff at 2) and CHA2DS2–VASc (C statistic 0.69, 95 % CI 0.65–0.73, P < 0.0001, optimal cutoff at 2) have compatible efficacy for stroke prediction in this Chinese population. Conclusion The CHADS2 and CHA2DS2–VASc scores can be used in patients who presented with arrhythmic symptoms to identify those who are at risk with developing new-onset clinical AF and ischemic stroke for close clinical surveillance and early intervention.
Persistent Identifierhttp://hdl.handle.net/10722/186056
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZuo, MLen_US
dc.contributor.authorLiu, Sen_US
dc.contributor.authorChan, KHen_US
dc.contributor.authorLau, GKKen_US
dc.contributor.authorChong, BHen_US
dc.contributor.authorLam, KFen_US
dc.contributor.authorChan, YHen_US
dc.contributor.authorLau, YFen_US
dc.contributor.authorLip, GYHen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorHse, HF-
dc.contributor.authorSiu, DCW-
dc.date.accessioned2013-08-20T11:50:23Z-
dc.date.available2013-08-20T11:50:23Z-
dc.date.issued2013en_US
dc.identifier.citationJournal of Interventional Cardiac Electrophysiology, 2013, v. 37 n. 1, p. 47-54en_US
dc.identifier.urihttp://hdl.handle.net/10722/186056-
dc.description.abstractBackground Early identification of individuals who are at risk of developing atrial fibrillation (AF) and ischemic stroke may enable a closer surveillance and thus prompt initiation of oral anticoagulation for stroke prevention. Objective This study sought to investigate whether congestive heart failure, hypertension, age ≥ 75 years, diabetes, previous stroke (CHADS2) and CHA2DS2–vascular disease, age 65–74 years, sex category (CHA2DS2–VASc) scores can predict new-onset AF and/or ischemic stroke in patients presenting with arrhythmic symptoms. Methods and results We prospectively followed up 528 patients (68.5 ± 10.6 years, male 46.2 %) presented for assessment of arrhythmic symptoms but without any documented arrhythmia, including AF for development of new-onset AF and/or ischemic stroke. Their mean CHADS2 and CHA2DS2–VASc scores on presentation were 1.3 ± 1.3 and 2.3 ± 1.5, respectively. After 6.1 years, 89 patients (16.8 %, 2.77 per 100 patient-years) had documented AF, and 65 patients (12.3 %, 2.0 per 100 patient-years) suffered stroke. Both the CHADS2 (C statistic 0.63, 95 % confidence interval (CI) 0.58–0.67, P < 0.0001, optimal cutoff at 1) and CHA2DS2–VASc (C statistic 0.63, 95 % CI 0.59–0.67, P < 0.0001, optimal cutoff at 2) scores provided similar prediction for the new-onset AF. Similarly, CHADS2 (C statistic 0.69, 95 % CI 0.65–0.73, P < 0.0001, optimal cutoff at 2) and CHA2DS2–VASc (C statistic 0.69, 95 % CI 0.65–0.73, P < 0.0001, optimal cutoff at 2) have compatible efficacy for stroke prediction in this Chinese population. Conclusion The CHADS2 and CHA2DS2–VASc scores can be used in patients who presented with arrhythmic symptoms to identify those who are at risk with developing new-onset clinical AF and ischemic stroke for close clinical surveillance and early intervention.-
dc.languageengen_US
dc.publisherSpringer. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=1383-875X-
dc.relation.ispartofJournal of Interventional Cardiac Electrophysiologyen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.titleThe CHADS2 and CHA2DS2–VASc scores predict new occurrence of atrial fibrillation and ischemic strokeen_US
dc.typeArticleen_US
dc.identifier.emailLiu, S: shasha99@hku.hken_US
dc.identifier.emailChan, KH: koonho@hku.hken_US
dc.identifier.emailLau, GKK: gkklau@hku.hken_US
dc.identifier.emailChan, YH: chanwill@hku.hken_US
dc.identifier.emailLau, CP: cplau@hku.hken_US
dc.identifier.authorityLiu, S=rp01628en_US
dc.identifier.authorityChan, KH=rp00537en_US
dc.identifier.authorityLau, GKK=rp01499en_US
dc.identifier.authorityChan, YH=rp01313en_US
dc.identifier.doi10.1007/s10840-012-9776-0-
dc.identifier.pmid23389054-
dc.identifier.hkuros220139en_US
dc.identifier.hkuros235561-
dc.identifier.volume37en_US
dc.identifier.spage47en_US
dc.identifier.epage54en_US
dc.identifier.isiWOS:000318505200007-

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