Document Detail


Roles of the CHADS2 and CHA2DS2-VASc scores in post-myocardial infarction patients: Risk of new occurrence of atrial fibrillation and ischemic stroke.
MedLine Citation:
PMID:  24846512     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients with myocardial infarction 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 myocardial infarction (STEMI) patients. 607 consecutive post-STEMI patients with no previously documented AF were studied. After a follow-up of 63 months (3,184 patient-years), 83 patients (13.7%) 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 ³3; and 0.39%, 1.72%, 1.83%, and 5.83% in patients with a CHA₂DS₂-VASc score of 1, 2, 3 and ³4. 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 ³3) and CHA₂DS₂-VASc scores (0.39%, 0.49%, 1.02%, and 1.48% with score of 1, 2, 3 and ³4). 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. This enables close surveillance and prompt anticoagulation for stroke prevention.
Authors:
Kui Kai Lau; Pak Hei Chan; Kai Hang Yiu; Yap Hang Chan; Shasha Liu; Koon Ho Chan; Chun Yip Yeung; Sheung Wai Li; Hung Fat Tse; Chung Wah Siu
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-20
Journal Detail:
Title:  Cardiology journal     Volume:  -     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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