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May 20, 2015European Heart JournalOpen Access

Patients with valve disease had a higher risk of thromboembolic events compared to those without (HR 1.39; 95% CI 1.14-1.69, P = 0.001), and a higher CHA2DS2-VASc score was independently associated with increased risk (HR 1.33, 95% CI 1.23-1.45, P < 0.0001).

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Why the study?

Does the presence of valvular heart disease increase the risk of stroke/thromboembolic events in patients with non-valvular atrial fibrillation, and does the CHA2DS2-VASc score accurately predict this risk?

Population

8,053 patients with non-valvular atrial fibrillation (ESC guidelines definition)

Comparison

Presence of valvular heart disease vs No valve disease (Group 1, n=6,851)

Design

Cohort

Follow-up

868 ± 1043 days

Authors

RPRaphaël PhilippartABAnne Brunet-BernardNCNicolas Clémenty

Discussion

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Overview

CHA2DS2-VASc stratifies stroke risk similarly with or without non-rheumatic valve disease; leaves open its role in guiding anticoagulation decisions.

Structured PICO

Does the presence of valvular heart disease increase the risk of stroke/thromboembolic events in patients with non-valvular atrial fibrillation, and does the CHA2DS2-VASc score accurately predict this risk?

P
Population
8,053 patients with non-valvular atrial fibrillation (ESC guidelines definition)
I
Intervention
Presence of valvular heart disease (excluding rheumatic mitral stenosis and valve prosthesis) (Group 2, n=1,202)
C
Comparator
No valve disease (Group 1, n=6,851)
O
Outcome
Stroke/thromboembolic (TE) eventshard clinical

In patients with non-valvular atrial fibrillation, concomitant left-sided valvular heart disease increases stroke and thromboembolic risk, which is adequately captured by a higher CHA2DS2-VASc score.

Cite This Study

Philippart et al. (2015) studied this question.

synapsesocial.com/papers/6a726567e71d69abee099482https://doi.org/10.1093/eurheartj/ehv163
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1CHA2DS2-VASc Score Is Associated With Prognosis in Patients With Acute Ischemic Stroke Without Atrial Fibrillation2025
  2. 2CHA<sub>2</sub>DS<sub>2</sub>VASc score and adverse outcomes in middle-aged individuals without atrial fibrillation2019 · 29 citations
  3. 3CHA<sub>2</sub>DS<sub>2</sub>VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation2015 · 19 citations
  4. 4Predictive role of CHADS<sub>2</sub> and CHA<sub>2</sub>DS<sub>2</sub>-VASc scores on stroke and thromboembolism in patients without atrial fibrillation: a meta-analysis2016 · 20 citations
  5. 5CHA<sub>2</sub>DS<sub>2</sub>-VASc score stratifies mortality risk in patients with and without atrial fibrillation2021 · 43 citations