Added Predictive Ability of the CHA2DS2VASc Risk Score for Stroke and Death in Patients With Atrial Fibrillation: The Prospective Danish Diet, Cancer, and Health Cohort Study.
Circ Cardiovasc Qual Outcomes. 2012 Apr 24;
Authors: Larsen TB, Lip GY, Skjøth F, Due KM, Overvad K, Hvilsted Rasmussen L
Abstract
BACKGROUND: DS(2)VASc prediction rule for stroke and death in a nonanticoagulated population of patients with atrial fibrillation. METHODS AND RESULTS: DS(2)VASc sore as an alternative to the CHADS(2) score. After 1-year follow-up, crude incidence rates were 3.4 per 100 person-years for stroke and 13.6 for death. After a mean follow-up of 5.4 years (±3.7 years), the crude incidence rates for stroke and death were 1.9 and 5.6, respectively. During the entire observation period, the c-statistics and negative predictive values were similar for both risk scores. The Net Reclassification Improvement analysis showed that 1 of 10 reclassified atrial fibrillation patients would have been upgraded correctly using the CHA(2)DS(2)VASc score. CONCLUSIONS: as well as the CHA(2)DS(2)VASc risk score can exclude a large proportion of patients from having high risk of stroke or death. However, using the CHA(2)DS(2)VASc risk score, fewer patients will fulfill the criterion for low risk (and are truly low risk for thromboembolism). For every 10 extra patients transferred to the treatment group at 5 years, using the CHA(2)DS(2)VASc risk score, 1 patient would have had a stroke that might have been avoided with effective treatment.
PMID: 22534406 [PubMed - as supplied by publisher]