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CHA2DS2VASc score and adverse outcomes in middle-aged individuals without atrial fibrillation

Giulia Renda1, Fabrizio Ricci2,3,4, Giuseppe Patti5

  • 1Institute of Cardiology, Department of Neuroscience, Imaging and Clinical Sciences, and Center of Excellence on Aging, CeSI-Met, G. d'Annunzio University, Chieti-Pescara, Italy.

European Journal of Preventive Cardiology
|August 15, 2019
PubMed

Insights

The CHA2DS2VASc score effectively predicts thromboembolic events and mortality in individuals with and without atrial fibrillation. Higher scores indicate increased risk for stroke, cardiovascular events, and death, aiding in risk stratification.

Area of Science:

  • Cardiology
  • Epidemiology
  • Preventive Medicine

Background:

  • The CHA2DS2VASc score is standard for assessing thromboembolic risk in non-valvular atrial fibrillation.
  • Its utility in predicting outcomes in individuals without atrial fibrillation is less understood.

Purpose of the Study:

  • To evaluate the prognostic value of the CHA2DS2VASc score for new-onset atrial fibrillation.
  • To assess cardiovascular morbidity and mortality risks associated with the CHA2DS2VASc score in a general population.

Main Methods:

  • Analysis of a population-based cohort (n=22,179) with and without atrial fibrillation history.
  • Stratification into CHA2DS2VASc score groups (0-1-2-3-≥4) to compare major adverse cerebro-cardiovascular events and mortality.
  • Assessment of annual atrial fibrillation incidence across CHA2DS2VASc strata.

Main Results:

  • CHA2DS2VASc score ≥4 in non-atrial fibrillation patients showed stroke risk similar to atrial fibrillation patients with CHA2DS2VASc 2.
  • The score demonstrated higher predictive accuracy for ischemic stroke in the non-atrial fibrillation group (AUC 0.60 vs. 0.56).
  • CHA2DS2VASc ≥2 independently predicted all-cause death, cardiovascular death, ischemic stroke, and coronary events. Annual AF incidence exceeded 2% for CHA2DS2VASc ≥4.

Conclusions:

  • The CHA2DS2VASc score is a valuable tool for predicting new-onset atrial fibrillation.
  • It also effectively predicts adverse cardiovascular outcomes in both atrial fibrillation and non-atrial fibrillation populations.
  • This score aids in comprehensive risk assessment across diverse patient groups.
Abstract

Keywords:
Atrial fibrillationanticoagulationcardiovascular riskischaemic strokethromboembolic risk

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