CHADS2, CHA2DS2-VASc and R2CHADS2 scores predict mortality in patients with coronary artery disease

Abstract

Few studies to date address the predictive ability of CHADS-VASc and RCHADS in CAD patients. Our aim is to investigate the prognostic performance of CHADS, CHADS-VASc and RCHADS scores in patients with coronary artery disease (CAD). Angiographically obstructive CAD patients were enrolled. The prognostic performance of the three risk scores was evaluated using Cox hazards models. In addition, we compared their predictive values by calculating C statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). The endpoints are death from any cause and cardiovascular death. Of 3295 subjects with CAD, the mean CHADS, CHADS-VASc and RCHADS scores are 1.2 ± 1.0, 2.4 ± 1.4, and 1.6 ± 1.4, respectively. The CHADS-guided risk classification is markedly distinct from CHADS--VASc- and RCHADS-guided ones. Over a median follow-up of 24 months, a total of 290 (rate 4.00/100 person-year) deaths occurred, and 163 (rate 2.2/100 person-year) were attributed to cardiovascular deaths. Event rates increase by CHADS, CHADS-VASc and RCHADS (P for trend <0.001). The multivariate analyses show 60, 111 and 82% higher risk of mortality per unit increase of CHADS, CHADS-VASc and RCHADS scores, respectively. Comparing with CHADS score (c-statistic = 0.61), CHADS-VASc (c-statistic 0.65, NRI 0.52 and IDI 0.06, P for all <0.05) and RCHADS (c-statistic 0.66, NRI 0.43 and IDI 0.09, P for all <0.05) scores provide better discrimination and reclassification for mortality. Also, CHADS-VASc and RCHADS have comparable predictive ability of mortality to the GRACE score. The CHADS, CHADS-VASc and RCHADS scores are simple yet robust prognostic tools in CAD patients.

Usefulness of the CHADS₂ and R₂CHADS₂ scores for prognostic stratification in patients with coronary artery disease

“… 15 In a recent study, Huang et al enrolled 3,295 subjects with CAD and found that R 2 CHADS 2 had comparable predictive ability of mortality to the Global Registry of Acute Coronary Events score. 16 Compared with the CHADS 2 score (c-statistic =0.61), the R 2 CHADS 2 (c-statistic =0.66, p <0.05) score provides better discrimination for mortality. The results of this study suggested that the R 2 CHADS 2 score could be used to predict composite events for patients with CAD, and the AUC of the R 2 CHADS 2 was statistically larger than of the CHADS 2 score.…”

CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non–ST-segment elevation acute coronary syndromes

“…[11] It has also been suggested that CHA2DS2-VASc score can provide prognostic information for ischemic events and mortality in patients with coronary artery disease, in patients undergoing PCI and in patients undergoing CABG surgery. [24][25][26][27] For this reason, the components of CHA2DS2-VASc score may be associated with increased ischemic risk, thrombotic risk, atherosclerotic process and micro vascular dysfunction, all of which take part in the mechanism and pathogenesis of no-reflow. [19,28,29] Similar to our study, studies investigating the effect of the CHA2DS2-VASc score on predicting no-reflow in ST segment elevated MI patients undergoing primary PCI have also found a relation between them.…”

Relationship between CHA2DS2-VASc and CHADS2 Scores with Pulmonary Hypertension in Patients with Acute Pulmonary Embolism

“…CHADS2 and CHA 2 DS 2 -VASc scores are clinical thromboembolic risk scores for predicting stroke in patients from the high-risk population and with non-valvular AF [13]. However, recent studies have demonstrated that both scores can predict mortality in various cardiovascular diseases, irrespective of the presence of AF [14,15]. In our study, the subjects with PH had significantly higher CHA 2 DS 2 -VASc and CHADS2 scores com-pared to the normal pulmonary pressure group.…”