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Article: Roles of the CHADS2 and CHA2DS2-VASc scores in post-myocardial infarction patients: Risk of new occurrence of atrial fibrillation and ischemic stroke

TitleRoles of the CHADS2 and CHA2DS2-VASc scores in post-myocardial infarction patients: Risk of new occurrence of atrial fibrillation and ischemic stroke
Authors
KeywordsCHADS2
CHA2DS2-VASc
Atrial fibrillation
Myocardial infarction
Issue Date2014
PublisherVia Medica. The Journal's web site is located at http://czasopisma.viamedica.pl/cj
Citation
Cardiology Journal, 2014, v. 21 n. 5, p. 474-483 How to Cite?
AbstractBackground: Patients with myocardial infarction (MI) are at risk of the development of atrial fibrillation (AF) and ischemic stroke. We sought to evaluate the prognostic performance of the CHADS2 and CHA2DS2-VASc scores in predicting new AF and/or ischemic stroke in post-ST segment elevation MI (STEMI) patients. Six hundred and seven consecutive post-STEMI patients with no previously documented AF were studied. Methods and Results: After a follow-up of 63 months (3,184 patient-years), 83 (13.7%) patients developed new AF (2.8% per year). Patients with a high CHADS2 and/or CHA2DS2-VASc score were more likely to develop new AF. The annual incidence of new AF was 1.18%, 2.10%, 4.52%, and 7.03% in patients with CHADS2 of 0, 1, 2, and ≥ 3; and 0.39%, 1.72%, 1.83%, and 5.83% in patients with a CHA2DS2-VASc score of 1, 2, 3 and ≥ 4. The CHA2DS2-VASc score (C-statistic = 0.676) was superior to the CHADS2 (C-statistic = 0.632) for discriminating new AF. Ischemic stroke occurred in 29 patients (0.9% per year), the incidence increasing in line with the CHADS2 (0.41%, 1.02%, 1.11%, and 1.95% with score of 0, 1, 2, and ≥ 3) and CHA2DS2-VASc scores (0.39%, 0.49%, 1.02%, and 1.48% with score of 1, 2, 3 and ≥ 4). The C-statistic of the CHA2DS2-VASc score as a predictor of ischemic stroke was 0.601, superior to that of CHADS2 score (0.573). CHADS2 and CHA2DS2-VASc scores can identify post-STEMI patients at high risk of AF and stroke. Conclusions: The CHADS2 and CHA2DS2-VASc scores can identify post-STEMI patients at high risk of AF and ischemic stroke. This enables close surveillance and prompt anticoagulation for stroke prevention.
Persistent Identifierhttp://hdl.handle.net/10722/198039
ISSN
2015 Impact Factor: 1.13
2015 SCImago Journal Rankings: 0.442
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLau, GKK-
dc.contributor.authorChan, PHM-
dc.contributor.authorYiu, KH-
dc.contributor.authorChan, YH-
dc.contributor.authorLiu, S-
dc.contributor.authorChan, KH-
dc.contributor.authorYeung, CY-
dc.contributor.authorLi, LSW-
dc.contributor.authorTse, HF-
dc.contributor.authorSiu, DCW-
dc.date.accessioned2014-06-25T02:42:06Z-
dc.date.available2014-06-25T02:42:06Z-
dc.date.issued2014-
dc.identifier.citationCardiology Journal, 2014, v. 21 n. 5, p. 474-483-
dc.identifier.issn1897-5593-
dc.identifier.urihttp://hdl.handle.net/10722/198039-
dc.description.abstractBackground: Patients with myocardial infarction (MI) are at risk of the development of atrial fibrillation (AF) and ischemic stroke. We sought to evaluate the prognostic performance of the CHADS2 and CHA2DS2-VASc scores in predicting new AF and/or ischemic stroke in post-ST segment elevation MI (STEMI) patients. Six hundred and seven consecutive post-STEMI patients with no previously documented AF were studied. Methods and Results: After a follow-up of 63 months (3,184 patient-years), 83 (13.7%) patients developed new AF (2.8% per year). Patients with a high CHADS2 and/or CHA2DS2-VASc score were more likely to develop new AF. The annual incidence of new AF was 1.18%, 2.10%, 4.52%, and 7.03% in patients with CHADS2 of 0, 1, 2, and ≥ 3; and 0.39%, 1.72%, 1.83%, and 5.83% in patients with a CHA2DS2-VASc score of 1, 2, 3 and ≥ 4. The CHA2DS2-VASc score (C-statistic = 0.676) was superior to the CHADS2 (C-statistic = 0.632) for discriminating new AF. Ischemic stroke occurred in 29 patients (0.9% per year), the incidence increasing in line with the CHADS2 (0.41%, 1.02%, 1.11%, and 1.95% with score of 0, 1, 2, and ≥ 3) and CHA2DS2-VASc scores (0.39%, 0.49%, 1.02%, and 1.48% with score of 1, 2, 3 and ≥ 4). The C-statistic of the CHA2DS2-VASc score as a predictor of ischemic stroke was 0.601, superior to that of CHADS2 score (0.573). CHADS2 and CHA2DS2-VASc scores can identify post-STEMI patients at high risk of AF and stroke. Conclusions: The CHADS2 and CHA2DS2-VASc scores can identify post-STEMI patients at high risk of AF and ischemic stroke. This enables close surveillance and prompt anticoagulation for stroke prevention.-
dc.languageeng-
dc.publisherVia Medica. The Journal's web site is located at http://czasopisma.viamedica.pl/cj-
dc.relation.ispartofCardiology Journal-
dc.subjectCHADS2-
dc.subjectCHA2DS2-VASc-
dc.subjectAtrial fibrillation-
dc.subjectMyocardial infarction-
dc.titleRoles of the CHADS2 and CHA2DS2-VASc scores in post-myocardial infarction patients: Risk of new occurrence of atrial fibrillation and ischemic stroke-
dc.typeArticle-
dc.identifier.emailLau, GKK: gkklau@hku.hk-
dc.identifier.emailChan, PHM: phmchan@hku.hk-
dc.identifier.emailYiu, KH: khkyiu@hku.hk-
dc.identifier.emailChan, YH: chanwill@hku.hk-
dc.identifier.emailLiu, S: shasha99@hku.hk-
dc.identifier.emailChan, KH: koonho@hku.hk-
dc.identifier.emailYeung, CY: ycy167@hku.hk-
dc.identifier.emailLi, LSW: lswli@hkucc.hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hk-
dc.identifier.authorityLau, GKK=rp01499-
dc.identifier.authorityChan, PHM=rp01864-
dc.identifier.authorityYiu, KH=rp01490-
dc.identifier.authorityChan, YH=rp01313-
dc.identifier.authorityLiu, S=rp01628-
dc.identifier.authorityChan, KH=rp00537-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authoritySiu, DCW=rp00534-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.5603/CJ.a2014.0034-
dc.identifier.pmid24846512-
dc.identifier.scopuseid_2-s2.0-84908296715-
dc.identifier.hkuros229236-
dc.identifier.volume21-
dc.identifier.issue5-
dc.identifier.spage474-
dc.identifier.epage483-
dc.identifier.isiWOS:000345995800005-
dc.publisher.placePoland-

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