Key result
CHADS2 and CHA2DS2-VASc scores predicted stroke in non-AF patients with pooled diagnostic odds ratios of 2.86 and 2.80 (95% CI 1.83-4.28), respectively.
Why the study?
Do CHADS2 and CHA2DS2-VASc scores accurately predict stroke and thromboembolism in patients without atrial fibrillation?
Meta-Analysis
Do CHADS2 and CHA2DS2-VASc scores accurately predict stroke and thromboembolism in patients without atrial fibrillation?
CHADS2 and CHA2DS2-VASc scores show good diagnostic accuracy and sensitivity for predicting stroke risk in non-AF patients, but poor specificity and inherent heterogeneity necessitate further validation.
Answers are grounded in this paper and cite their sources.
May aid stroke risk stratification in non-AF patients; extends CHA2DS2-VASc utility but requires prospective validation.
OBJECTIVE: CHA2DS2-VASc is the extension of the CHADS2 score developed by Birmingham 2009. This risk stratification schema is often used in clinical setting when considering additional risk factors for developing stroke in AF patients. However, its role in the non-AF population is unknown. This study was designed to evaluate the accuracy of the CHADS2 and the CHA2DS2-VASc scoring systems. METHODS: Studies designed for CHADS2 and CHA2DS2-VASc score in stratifying the risks for stroke development in non-AF patients were included. RESULTS: Among the 114 studies identified, six trials were chosen finally and included for meta-analysis. The pooled diagnostic odds ratio (DOR) for CHADS2 and CHA2DS2-VASc was 2.86 (95% CI =1.83-4.28) and 2.80 (95% CI =1.83-4.28), respectively. CHA2DS2-VASc score was of better sensitivity than CHADS2 score (0.920 vs. 0.768). However, both scores were showed to have inherent heterogeneity and poor specificity. CONCLUSIONS: Though having good diagnostic accuracy, the clinical application of the CHADS2 and CHA2DS2-VASc scores in predicting risk of stroke development in non-AF patients still needs further validation. Key message The overall diagnostic accuracy of CHADS2 and CHA2DS2-VASc in stroke-risk stratification was good in patients with non-atrial fibrillation.
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Liu et al. (2016) conducted a meta-analysis in Non-atrial fibrillation. CHA2DS2-VASc score vs. CHADS2 score was evaluated on Stroke and thromboembolism (DOR 2.80, 95% CI 1.83-4.28). CHADS2 and CHA2DS2-VASc scores predicted stroke in non-AF patients with pooled diagnostic odds ratios of 2.86 and 2.80 (95% CI 1.83-4.28), respectively.
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