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

Abstract

ObjectiveThe current risk model for long-term prediction in coronary artery disease (CAD) is complicated, while a simple useful model is still lacking. We aim to investigate if CHADS2 and R2CHADS2 scores could predict long-term outcome for patients with CAD.Patients and methodsWe enrolled 3,700 patients with CAD between November 2010 and September 2014 at the Department of Cardiology from Chinese PLA General Hospital. The CHADS2 and R2CHADS2 scores were calculated. All cases were followed to track the incidence of composite end point consisting of cardiovascular (CV) death, myocardial infarction (MI), stroke, heart failure, and all-cause death.ResultsDuring a median 2.9-year follow-up, 443 patients experienced at least one element of the composite end point of CV death (n=168 [4.6%]), MI (n=59 [1.6%]), stroke (n=96 [2.6%]), heart failure (n=101 [2.8%]), and all-cause death (n=240 [6.6%]). Multivariate Cox regression analyses showed that the CHADS2 score (hazard ratio [HR]: 2.18, 95% CI: 2.00–2.38, p<0.0001) and the R2CHADS2 score (HR: 1.93, 95% CI: 1.83–2.04, p<0.0001) were independently associated with composite outcome. Receiver-operating characteristic analysis showed that compared with the CHADS2 score, the R2CHADS2 score had better discrimination for the prediction of long-term combined outcome (0.772 vs 0.791, p=0.0013).ConclusionCHADS2 and R2CHADS2 scores provide a quick and useful tool in predicting long-term outcome for patients with CAD.

Evaluation of coronary artery disease in patients with atrial fibrillation by cardiac computed tomography for catheter ablation: CADAF-CT trial

“…1) (p = 0.003). These findings may support the previous findings that a high CHADS 2 score has been proven to be a predictor of cardiovascular/cerebrovascular events in patients with documented CAD [4,5]. Moreover, it has been reported that approximately 75% of culprit Fig.…”

“…1 3 [2], but also a new onset of AF [3]. Moreover, the CHADS 2 score is constructed by risk factors of coronary artery disease (CAD), and has also been reported as a predictor of cardiovascular/cerebrovascular events in patients with CAD without AF [4,5]. The close relationship between AF and CAD has been reported [6], and that (1) the prevalence of CAD detected by coronary computed tomography (CT) is significantly higher in patients with AF than in those without [7], and (2) coronary angiography (CAG) can detect coronary narrowing (≥ 50%) in patients with AF who undergo RFCA of AF [8].…”

Using CHADS2 and CHA2DS2-VASc scores for mortality prediction in patients with chronic kidney disease

“…However, CHA 2 DS 2 -VASc score had recently become a more useful score and outperformed CHADS 2 score for prediction of stroke and systemic embolization 12 , 14 . In addition, both of CHADS 2 and CHA 2 DS 2 -VASc scores were also used to predict CV outcomes in non-AF patients 9 – 11 , 15 – 17 . Chen et al reported that CHADS 2 and CHA 2 DS 2 -VASc scores could be used to predict 1-year all-cause mortality in patients with systolic heart failure 15 .…”

“…In AF patients, there is a strong association between the CHADS 2 score and the annual risk of stroke 7 , 8 . In addition, CHADS 2 score was used to predict CV outcomes in the patients without AF 9 – 11 . Nevertheless, in recent years, CHA 2 DS 2 -VASc score has become a more useful score than CHADS 2 score for prediction of stroke and systemic embolization in AF patients 12 – 14 .…”

Using CHADS2, R2CHADS2, CHA2DS2-VASc score for mortality prediction in patients with abnormal low and high ankle-brachial index

“…International Publisher used to predict CV outcomes in the patients without AF [17][18][19][20][21][22][23][24][25]. However, there was no literature discussing about the usefulness of CHADS 2 , R 2 CHADS 2 and CHA 2 DS 2 -VASc score for CV and all-cause mortality prediction in the patients with abnormal low and high ABI.…”