Key result
The Delta CHA2DS2-VASc score over follow-up is not static and may be a stronger predictor of ischaemic stroke in atrial fibrillation patients than atrial fibrillation burden alone.
The authors suggest that changes in the CHA2DS2-VASc score over time (Delta score) should be evaluated as a potentially stronger predictor of ischemic stroke than atrial fibrillation burden alone.
The article by Uittenbogaart et al.1 published in Europace describing the relationship between atrial fibrillation (AF) burden and risk of stroke elucidated great interest among researcher of our working group. The authors reported that patients with atrial high rate episodes burden over 6 min have an increased risk for stroke. Of note, despite advantages in the treatment of AF, the mortality rate is two-fold high within the last 20 years.2,3 The burden of AF is increased in presence of risk factors.4 Certainly, we would like to acknowledge the authors to the fact that the Delta CHA2DS2-VASc score, between the baseline and over follow-up, is not static and is strongly predictive of ischaemic stroke in AF patients.5 Since all these studies analysed by the working group have not evaluated Delta CHA2DS2-VASc score, it is not excluded that the risk of ischaemic stroke is more associated with the Delta CHA2DS2-VASc score than the burden of AF. Therefore, more evidence of Delta CHA2DS2-VASc score is required for finding the time-dependent risk factor development before giving any final conclusions. Conflict of interest: none declared.
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El‐Battrawy et al. (2018) conducted a letter in Atrial fibrillation. Delta CHA2DS2-VASc score was evaluated on Ischaemic stroke. The Delta CHA2DS2-VASc score over follow-up is not static and may be a stronger predictor of ischaemic stroke in atrial fibrillation patients than atrial fibrillation burden alone.
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