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January 1, 2014Polish Journal of Cardio-Thoracic SurgeryOpen Access

CARDIAC SURGERY Truly low and high thromboembolic risk – impact of risk scores in real life

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Why the study?

Does risk stratification with the CHA2DS2-VASc score improve the identification of high thromboembolic risk in patients with nonvalvular atrial fibrillation compared to the CHADS2 score?

Population

68 consecutive patients with sustained nonvalvular atrial fibrillation who had not yet received…

Comparison

Risk stratification using CHA2DS2-VASc and… vs Risk stratification using the CHADS2 score.

Design

Cohort

Follow-up

18 ± 2.35 months

Key result

The CHA2DS2-VASc score identified an additional 26 patients (43% of those requiring anticoagulation) at high risk for thromboembolic complications who would have been classified as lower risk by the CHADS2 score.

Authors

TCTomasz CiuruśSSSebastian SobczakMLMałgorzata Lelonek

Discussion

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Overview

May support preferring CHA2DS2-VASc over CHADS2 for AF risk stratification; leaves open whether this improves outcomes.

Study Design

Type

Observational (n=68)

Multicenter

No

Structured PICO

Does risk stratification with the CHA2DS2-VASc score improve the identification of high thromboembolic risk in patients with nonvalvular atrial fibrillation compared to the CHADS2 score?

P
Population
68 patients (mean age 66, 47% female) with nonvalvular atrial fibrillation, previously untreated with anticoagulants, followed for 18 months to evaluate risk stratification scores.
E
Exposure
Risk stratification using CHA2DS2-VASc and HAS-BLED scores, with warfarin therapy initiated for patients at high thromboembolic risk.
C
Comparator
Risk stratification using the CHADS2 score (specifically comparing patients with CHADS2 ≥ 2 vs. CHADS2 < 2 and CHA2DS2-VASc ≥ 2).
O
Outcome
Thromboembolic complications (stroke/TIA, peripheral embolism) and bleeding events (major and minor) during 18 months of follow-up.hard clinical

The CHA2DS2-VASc score effectively identifies a significant proportion of AF patients at high thromboembolic risk who would otherwise be classified as low or intermediate risk by the CHADS2 score.

Limitations

  • Small study group
  • Multivariate analysis was not performed
  • Data analyzed from a single academic center
  • Data from a single academic center

Cite This Study

Ciuruś et al. (2014) conducted an observational in Nonvalvular atrial fibrillation (n=68). CHA2DS2-VASc and HAS-BLED risk stratification vs. CHADS2 risk stratification was evaluated on Reclassification of thromboembolic risk. The CHA2DS2-VASc score identified an additional 26 patients (43% of those requiring anticoagulation) at high risk for thromboembolic complications who would have been classified as lower risk by the CHADS2 score.

synapsesocial.com/papers/6a74561c4d9108bbdbdb6124https://doi.org/10.5114/kitp.2014.41921
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