Comparative assessment of published atrial fibrillation stroke risk stratification schemes for predicting stroke, in a non-atrial fibrillation population: The Chin-Shan Community Cohort Study

Lip, Gregory Y.H.; Lin, Hung‐Ju; Chien, Kuo–Liong; Hsu, Hua‐Yi; Su, Ta‐Chen; Chen, Ming-Fong; Lee, Yuan‐Teh

doi:10.1016/j.ijcard.2012.09.148

Cited by 62 publications

(48 citation statements)

References 32 publications

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“…The CHA 2 DS 2 ‐VASc score has been proved to be more sensitive than the CHADS 2 score to predict cardio‐embolic events in AF patients 7. In recent years, the use of the CHA 2 DS 2 ‐VASc score in predicting ischemic stroke, thromboembolism, and death has extended beyond the originally proposed AF field 8, 9. It has been reported that high CHA 2 DS 2 ‐VASc score are associated with mortality in patients with acute coronary syndrome,10 irrespective of the presence or absence of AF.…”

Section: Introductionmentioning

confidence: 99%

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

et al. 2016

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AimsAtrial fibrillation (AF) is common in patients with heart failure (HF). CHA2DS2‐VASc score was originally employed as a risk assessment tool for stroke in patients with AF; however, it has recently been used to predict not only stroke but also various cardiovascular diseases beyond the original AF field. We aimed to verify the CHA2DS2‐VASc score as a risk assessment tool to predict mortality in patients with HF.Methods and ResultsConsecutive 1011 patients admitted for treatment of HF were divided into three groups based on their CHA2DS2‐VASc scores: score 1–3 group (n = 317), score 4–6 group (n = 549) and score 7–9 group (n = 145). Of the 1011 HF patients, 387 (38.3%) had AF. We compared patient characteristics among the three groups and prospectively followed for all‐cause mortality. Although left ventricular ejection fraction was similar among all three groups, all‐cause mortality was higher in the score 4–6 group and score 7–9 group than in the score 1–3 group (37.9 and 29.3% vs. 15.1%, log‐rank P < 0.001). In the multivariable Cox proportional hazard analysis, the CHA2DS2‐VASc score 7–9 was an independent predictor of all‐cause mortality (all HF patients: hazard ratio (HR) 1.822, P = 0.011; HF patients with AF: HR 1.951, P = 0.031; HF patients without AF: HR 2.215, P = 0.033).ConclusionsThe CHA2DS2‐VASc score was an independent predictor of all‐cause mortality in HF patients with or without AF. This comprehensive risk assessment score may help identify HF patients who are at high risk for mortality in HF patient.

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Section: Introductionmentioning

confidence: 99%

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

et al. 2016

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“…9,10 These clinical tools have predictive capacity for adverse outcomes even in patients without known AF, including the risk of death after stroke, the risk of incident AF, and the risk of stroke in unselected patients, in patients with stable coronary artery or after an acute coronary syndrome. [11][12][13][14][15][16] A better identification of the risk of incident AF in patients with ischemic stroke is currently a challenge. We aimed to identify patients with ischemic stroke without prior diagnosed AF who are at higher risk of developing or having a subsequent diagnosis of incident AF based on multiple risk factors.…”

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Patients With Ischemic Stroke and Incident Atrial Fibrillation

Fauchier

Clémenty

Pelade

et al. 2015

Stroke

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“…The CHADS 2 and the CHA 2 DS 2 VASc scores have been shown to be associated with the risk of stroke in non-AF patients with ischemic heart disease, 5,6 in patients undergoing coronary artery bypass grafting, 7,8 in patients with acute coronary syndrome, 9 and in addition, the scores hold promise for stroke and thromboembolism risk assessment in the general population. 10 Risk stratification is of particular interest in patients with ischemic stroke as they are at high risk of a stroke recurrence (18% over a 5-year period 11,12 ), and the recurrence risk is nonuniform across the population. A study based on the Athens Stroke Registry 13 reported that the CHADS 2 and the CHA 2 DS 2 VASc scores predict recurrent stroke and death in non-AF stroke patients.…”

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Recurrent Stroke

Andersen

Gorst‐Rasmussen

Lip

et al. 2015

Stroke

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Background and Purpose-The CHA 2 DS 2 VASc score and the Essen Stroke Risk Score are respectively used for risk stratification in patients with atrial fibrillation and in patients with cerebrovascular incidents. We aimed to test the ability of the 2 scores to predict stroke recurrence, death, and cardiovascular events (stroke, transient ischemic attack, myocardial infarction, or arterial thromboembolism) in a nationwide Danish cohort study, among patients with incident ischemic stroke and no atrial fibrillation. Methods-We conducted a registry-based study in patients with incident ischemic stroke and no atrial fibrillation. Patients were stratified according to the CHA 2 DS 2 VASc score and the Essen Stroke Risk Score and were followed up until stroke recurrence or death. We estimated stratified incidence rates and hazard ratios and calculated the cumulative risks. Results-42 182 patients with incident ischemic stroke with median age 70.1 years were included. The overall 1-year incidence rates of recurrent stroke, death, and cardiovascular events were 3.6%, 10.5%, and 6.7%, respectively. The incidence rates, the hazard ratios, and the cumulative risk of all outcomes increased with increasing risk scores. C-statistics for both risk scores were around 0.55 for 1-year stroke recurrence and cardiovascular events and correspondingly for death around 0.67 for both scores. Conclusions-In this cohort of non-atrial fibrillation patients with incident ischemic stroke, increasing CHA 2 DS 2 VASc score and Essen Stroke Risk Score was associated with increasing risk of recurrent stroke, death, and cardiovascular events. Their discriminatory performance was modest and further refinements are required for clinical application.

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Comparative assessment of published atrial fibrillation stroke risk stratification schemes for predicting stroke, in a non-atrial fibrillation population: The Chin-Shan Community Cohort Study

Cited by 62 publications

References 32 publications

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

Patients With Ischemic Stroke and Incident Atrial Fibrillation

Recurrent Stroke

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Comparative assessment of published atrial fibrillation stroke risk stratification schemes for predicting stroke, in a non-atrial fibrillation population: The Chin-Shan Community Cohort Study

Cited by 62 publications

References 32 publications

The CHA2DS2‐VASc score as a predictor of high mortality in hospitalized heart failure patients

The CHA2DS2‐VASc score as a predictor of high mortality in hospitalized heart failure patients

Patients With Ischemic Stroke and Incident Atrial Fibrillation

Recurrent Stroke

Contact Info

Product

Resources

About

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients

The CHA₂DS₂‐VASc score as a predictor of high mortality in hospitalized heart failure patients