Predictive value of CHA2DS2-VASc scores regarding the risk of stroke and all-cause mortality in patients with atrial fibrillation (CONSORT compliant)

Abstract

Background: Patients with atrial fibrillation (AF) have a higher risk of fatal complications (e.g., stroke). This investigation was performed as an observational retrospective cohort study includes 137 patients (age 61 ± 15; 34.3% women) with a primary diagnosis of AF (paroxysmal, persistent, and permanent). Methods: We collected information about the drug therapy, comorbidities and survival of AF patients and determined their congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA 2 DS 2 -VASc) scores. Statistical analysis identified patients with high CHA 2 DS 2 -VASc scores and defined the predictive value of individual parameters, or their combination, with regards to the outcomes of stroke and mortality. Results: CHA 2 DS 2 -VASc scores identified 43.8% of the patients as low to intermediate risk (score 0–1) and 56.2% of the patients as high risk (score ≥2). Increasing CHA 2 DS 2 -VASc scores were not only accompanied by an increase in the incidence of stroke ( P trend < .001) but also by an increase in the 3 to 5 years mortality ( P = .005). Comparison of anticoagulation and anti-aggregation treatment between the 3 groups of AF did not show any significant statistical difference. Highly significant predictors of death were the CHA 2 DS 2 -VASc score (OR 1.71, 95% CI 1.10–2.67, P < .017) as well as other risk factors not included in the CHA 2 DS 2 -VASc score such as valvular heart disease (OR 5.04, 95% CI 1.10-23.10, P = .037), hyperlipidemia (OR 4.82, 95% CI 1.03–22.63, P = .046) and chronic renal failure (OR 14.21, 95% CI 2.41–83.91, P = .003). The type of AF type did not affect survival ( P = .158) nor the incidence of stroke ( P = .466). Patients with paroxysmal AF were linked to significantly lower frequencies of ischemic heart disease ( P < .0001), vascular disease ( P = .002), diabetes mellitus ( P = .047), valvular heart disease ( P = .03) and heart failure/left ventricular dysfunction ( P = .015). Conclusion: The CHA 2 DS 2 -VASc score correctly predicted the patients at high-risk for 3 to 5 years mortality and confirmed its significant predictive value in th...

Is the Median Hourly Ambulatory Heart Rate Range Helpful in Stratifying Mortality Risk among Newly Diagnosed Atrial Fibrillation Patients?

“…In addition, the cut-off value of 20 bpm was found to be potentially useful in clinical practice to categorize AF patients into low and high risk groups. Additionally, we discovered that the combination of AHRR 24hr and the CHA2DS2-VASc score had a higher association with the all-cause mortality than the use of AHRR 24hr or the CHA2DS2-VASc score alone, which was similar across our study and previous studies [2,[24][25][26]. Though few prior studies provided comparisons between the CHA2DS2-VASc score and measurements on cardiac rhythm.…”

“…In addition to Holter parameters, demographic features around the date of the Holter ECG recording were collected, including age, gender, co-morbidities, medications, and laboratory findings. The CHA2DS2-VASc score was also calculated as an individual covariate due to its high associations with mortality among AF patients [2,[24][25][26]. Allcause mortality was set as the primary endpoint, and every patient was followed until that point or 30 June 2017.…”

CHA2DS2-VASc Score as a Predictor for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation: A Meta-Analysis

“…Atrial fibrillation (AF) is a fairly common arrhythmia worldwide, and 33 million people are estimated to be suffering from this condition [ 1 ]. Worryingly, the left atrial thrombus (LAT) and left atrial spontaneous echo contrast (LASEC) formation, which are among the most frequent complications that develop in patients with AF, are related to high rates of stroke and mortality [ 2 – 4 ]. The transesophageal echocardiography (TEE) is considered the global standard for detecting LAT with 97% sensitivity and 100% specificity [ 5 , 6 ].…”

Elderly patients with atrial fibrillation in routine clinical practice—peri-procedural management of edoxaban oral anticoagulation therapy is associated with a low risk of bleeding and thromboembolic complications: a subset analysis of the prospective, observational, multinational EMIT-AF study

“…Peri-procedural EHRA bleeding risk [ 16 ]; HAS-BLED [ 17 ] (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs/alcohol concomitantly) score; CHA 2 DS 2 -VASc (Congestive heart failure, Hypertension, Age ≥ 75 [doubled], Diabetes, Stroke [doubled]-Vascular disease, Age 65–74 years, and gender [female]) score [ 18 ]; details of edoxaban treatment; diagnostic/therapeutic procedures; and clinical findings were documented at baseline and during the peri-procedural period.…”

“…Peri-procedural EHRA bleeding risk [16]; HAS-BLED [17] [18]; details of edoxaban treatment; diagnostic/therapeutic procedures; and clinical findings were documented at baseline and during the peri-procedural period.…”