Document Detail


The CHADS(2) and CHA (2)DS (2)-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke.
MedLine Citation:
PMID:  23389054     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: 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 (CHADS(2)) and CHA(2)DS(2)-vascular disease, age 65-74 years, sex category (CHA(2)DS(2)-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 CHADS(2) and CHA(2)DS(2)-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 CHADS(2) (C statistic 0.63, 95 % confidence interval (CI) 0.58-0.67, P < 0.0001, optimal cutoff at 1) and CHA(2)DS(2)-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, CHADS(2) (C statistic 0.69, 95 % CI 0.65-0.73, P < 0.0001, optimal cutoff at 2) and CHA(2)DS(2)-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 CHADS(2) and CHA(2)DS(2)-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.
Authors:
Ming-Liang Zuo; Shasha Liu; Koon-Ho Chan; Kui-Kai Lau; Boon-Hor Chong; Kwok-Fai Lam; Yap-Hang Chan; Yuk-Fai Lau; Gregory Y H Lip; Chu-Pak Lau; Hung-Fat Tse; Chung-Wah Siu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-7
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  -     ISSN:  1572-8595     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China.
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