Usefulness of the CHADS2 and R2CHADS2 scores for prognostic stratification in patients with coronary artery disease

Objective: The current risk model for long-term prediction in coronary artery disease (CAD) is complicated, while a simple useful model is still lacking. We aim to investigate if CHADS 2 and R 2 CHADS 2 scores could predict long-term outcome for patients with CAD. Patients and methods: We enrolled 3,700 patients with CAD between November 2010 and September 2014 at the Department of Cardiology from Chinese PLA General Hospital. The CHADS 2 and R 2 CHADS 2 scores were calculated. All cases were followed to track the incidence of composite end point consisting of cardiovascular (CV) death, myocardial infarction (MI), stroke, heart failure, and all-cause death. Results: During a median 2.9-year follow-up, 443 patients experienced at least one element of the composite end point of CV death (n=168 [4.6%]), MI (n=59 [1.6%]), stroke (n=96 [2.6%]), heart failure (n=101 [2.8%]), and all-cause death (n=240 [6.6%]). Multivariate Cox regression analyses showed that the CHADS 2 score (hazard ratio [HR]: 2.18, 95% CI: 2.00–2.38, p <0.0001) and the R 2 CHADS 2 score (HR: 1.93, 95% CI: 1.83–2.04, p <0.0001) were independently associated with composite outcome. Receiver-operating characteristic analysis showed that compared with the CHADS 2 score, the R 2 CHADS 2 score had better discrimination for the prediction of long-term combined outcome (0.772 vs 0.791, p =0.0013). Conclusion: CHADS 2 and R 2 CHADS 2 scores provide a quick and useful tool in predicting long-term outcome for patients with CAD.