Navigation Links
CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk
Date:8/31/2013

In contrast, a CHA2DS2-VASc score of 0 identifies a subgroup of patients with very low stroke risk unlikely to benefit from anticoagulation treatment.

Professor Nabauer said: "AF is the most frequent cardiac arrhythmia requiring hospitalisation and has a 1-2% prevalence in the general population. AF is associated with a significant risk of stroke with frequently disabling consequences. While oral anticoagulation is very effective in preventing ischaemic strokes in AF, it increases bleeding risk. Identification of patients with low risk of stroke not requiring oral anticoagulation is important to maximise anticoagulation benefit while avoiding the cost, hassle, and bleeding risk of oral anticoagulation."

The present study tested stroke risk stratification schemes for identifying patients with very low stroke risk who may not benefit from oral anticoagulation. The analysis was based on the prospective registry of the German Competence Network on Atrial Fibrillation (AFNET) which started in 2004-2006 and includes 9,575 patients with AF. Follow-up was for a mean of 5.1 years, and stroke events were adjudicated by a critical event committee.

On enrolment, 47.7% of patients with non-valvular AF (n=8,847) in the AFNET registry were assigned a CHADS2 score of 0 (16.2%) or 1 (31.5%) indicating that oral anticoagulation was not definitively recommended. Surprisingly, 35.8% (145 out of 405) of strokes and other thromboembolic events (transient ischaemic attack, systemic embolism) during follow-up occurred in this patient subgroup initially classified by CHADS2 to have low or intermediate stroke risk (CHADS2=0: 45, CHADS2=1: 100 events).

Professor Nabauer said: "This finding suggests that classes CHADS2 0 and 1 contain subgroups of patients with significant stroke risk that may be identified by refined stroke risk stratification."

The CHA2DS2-VASc score, which adds age 65-74 years, vascular disease and female gender as stroke risk factors to the CHADS2 score, has been put forward to improve risk stratification in patients with low stroke risk and is the recommended risk stratification scheme in the ESC Guidelines on atrial fibrillation.1,2

In the current study, application of the CHA2DS2-VASc score reclassified 53.8% of patients with CHADS2 scores 0 or 1 to a CHA2DS2-VASc score of 2 and higher, where oral anticoagulation is the recommended treatment. Conversely, CHA2DS2-VASc assigned a very low stroke risk score of 0 to 55.6% of patients previously classified as CHADS2=0 (9.0% of all patients).

Professor Nabauer said: "Only 8 strokes and other thromboembolic events were observed in these patients classified as CHA2DS2-VASc=0 during the follow-up period (strokes occurring in association with cardioversion or ablation were excluded). This finding supports the use of CHA2DS2-VASc stroke risk stratification to identify patients at very low stroke risk who may not benefit from oral anticoagulation for ischaemic stroke prevention."

He concluded: "A CHADS2 score of 0 or 1 does not appear to be suitable to identify patients with AF at low risk for stroke while CHA2DS2-VASc picks up these patients. The risk of stroke in patients with a CHA2DS2-VASc score of 0 over a mean follow up of 5.1 years was very low. Our data support the current recommendation that oral anticoagulation is not beneficial in patients with 'lone AF' or a CHA2DS2-VASc score of 0."


'/>"/>

Contact: Celine Colas
press@escardio.org
44-773-005-7146
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Liberty University Student Scores Among Highest in Nation on Medical School Entrance Exam
2. Natures Tears® EyeMist® Celebrates Perfect Score on Walgreens.com
3. New method successfully scores joint damage in rheumatoid arthritis
4. Prompt Alert® Scores Prominent Berth on PROFIT Magazine's 2013 List of Canada's Fastest-Growing Companies
5. Tennis Score Tracker 3.0 Now Available - The Most Advanced Tennis Scorekeeper for the iPhone, iPad, iPod touch, with Detailed Statistics, Live Scoring, 20+ New Features
6. Mirena IUD Lawsuit Update: Supreme Court of New Jersey Centralizes Litigation; Parker Waichman LLP Underscores the Advantages of this Decision
7. Top 2013 Idaho Home Security Alarm System Companies Scored by 6Webs.com
8. 7 Mile Bridge Death Underscores Victim Rights
9. DCIS Score quantifies risk of IBE
10. Best 2013 Colorado Burglar Alarm System Companies Scored by 6Webs.com
11. Best 2013 California Home alarm System Companies Scored by 6Webs.com
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... 2016 , ... Today, MTI-GlobalStem, a provider of optimized transfection ... to transfect cells, announces its launch of the PluriQ™ G9™ Gene Editing System ... is a complete system for culturing and transfecting human pluripotent stem cells for ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... and infrastructure. Most providers, however, are unsure how to move forward, given the ... to define a path forward tailored to an organization’s specific needs. , PYA ...
(Date:6/24/2016)... ... ... SpiritQuest Sedona Retreats, located in Arizona has re-located to 75 Kallof Place, ... Rock, Airport Mesa, and Boynton Canyon. The new retreat center is ideally-situated ... the Sedona Rouge, both popular accommodations for SpiritQuest clients. The Medicine Wheel, Labyrinth ...
(Date:6/23/2016)... ... 2016 , ... An article published June 8 on AOL News ... neck cancer in individuals with unhealthy oral hygiene habits. The article goes on to ... had gum disease, brushed their teeth on a daily basis, wore dentures and if ...
(Date:6/23/2016)... ... June 23, 2016 , ... SyncDog, Inc. ... mobile security software, is featured in the current issue of Silicon Review ... companies with innovative technology solutions and features them in their magazine. The magazine ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016  American Respiratory Labs (ARL), a ... now able to perform sophisticated lung assessments in patients, homes, thanks ... Inc. Patients are no longer limited to having ... PRO ® , ARL patients like Jeanne R. of ... the comfort of her own home. ...
(Date:6/24/2016)... , June 24, 2016   Pulmatrix, Inc ... company developing innovative inhaled drugs, announced today that it ... Russell Investments reconstituted its comprehensive set of U.S. ... "This is an important milestone for Pulmatrix," said ... increase shareholder awareness of our progress in developing drugs ...
(Date:6/23/2016)... HOUSTON , June 23, 2016  MedSource ... platform as its e-clinical software solution of choice.  ... the best possible value to their clients by ... nowEDC.  The preferred relationship establishes nowEDC as the ... pricing for MedSource,s full-service clients.  "nowEDC has long ...
Breaking Medicine Technology: