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- Title
The CHADS and CHADS-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke.
- Authors
Zuo, Ming-Liang; Liu, Shasha; Chan, Koon-Ho; Lau, Kui-Kai; Chong, Boon-Hor; Lam, Kwok-Fai; Chan, Yap-Hang; Lau, Yuk-Fai; Lip, Gregory; Lau, Chu-Pak; Tse, Hung-Fat; Siu, Chung-Wah
- Abstract
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) and CHADS-vascular disease, age 65-74 years, sex category (CHADS-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 and CHADS-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 (C statistic 0.63, 95 % confidence interval (CI) 0.58-0.67, P < 0.0001, optimal cutoff at 1) and CHADS-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 (C statistic 0.69, 95 % CI 0.65-0.73, P < 0.0001, optimal cutoff at 2) and CHADS-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 and CHADS-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.
- Subjects
ATRIAL fibrillation risk factors; STROKE; EMBOLISMS; ARRHYTHMIA; HEART failure
- Publication
Journal of Interventional Cardiac Electrophysiology, 2013, Vol 37, Issue 1, p47
- ISSN
1383-875X
- Publication type
Article
- DOI
10.1007/s10840-012-9776-0