Abstract:
ObjectiveTo compare the results of ischemic stroke risk assessment in patients with newly diagnosed non-valvular atrial fibrillation(AF) using CHADS
2(congestive heart failure,hypertension,age≥75 years,diabetes,prior stroke or transient ischemic attack or thromboembolismdoubled) and CHA
2DS
2-VASc(congestive heart failure,hypertension,age≥75 yearsdoubled,diabetes,prior stroke or transient ischemic attack or thromboembolismdoubled,vascular disease,age 65-74 years,sex category) classification schemes for the appropriate application of the schemes among Chinese patients.
MethodsWith prospective cohort design,the stroke risk of 143 patients with newly diagnosed non-valvular atrial fibrillation were assessed using CHADS
2 and CHA
2DS
2-VASc score and the results of assessment with the two schemes were compared.
ResultsThe average score of CHA
2DS
2-VASc was significantly higher than that of CHADS
2(2.36±1.97 vs.1.51±1.28,
P<0.01).Based on the scores of CHADS
2,the proportions of the patients with low,intermediate,and high stroke risk were 32.2%(46/143),29.4%(42/143),and 38.5%(55/143),while based on the scores of CHA
2DS
2-VASc,the proportions were 13.3%(19/143),22.4%(32/143),and 64.3%(92/143),respectively,with a significantly lower proportion of low stroke risk(
χ2=4.57,
P<0.01)and a significantly higher proportion of high stoke risk(
χ2=20.76,
P<0.05) for using CHA
2DS
2-VASc compared to using CHADS
2.During the two-year follow-up,the number of stroke incident in the patients with low,intermediate,and high stroke risk assessed with CHADS
2 were 1,2,and 3,whereas the number were 0,0,6 assessed with CHA
2DS
2-VASc,respectively.
ConclusionCompared to with CHADS
2,stroke risk assessment with CHA
2DS
2-VASc results in a lower proportion of low risk and a higher proportion of high risk among newly diagnosed Chinese non-valvular AF patients.