CHA2DS2-VASc score not static; most a-fib patients develop new risk factor before ischemic stroke
TUESDAY, Jan. 9, 2018 (HealthDay News) — Assessing change in the CHA2DS2-VASc score over time is more predictive of ischemic stroke in patients with atrial fibrillation (AF) than the baseline score, according to a study published in the Jan. 16 issue of the Journal of the American College of Cardiology.
Tze-Fan Chao, M.D., from the Taipei Veterans General Hospital in Taiwan, and colleagues compared the effectiveness of assessing ischemic stroke risk in 31,039 patients with AF using the CHA2DS2-VASc score, based on the baseline risk factors, and the Delta CHA2DS2-VASc score, which reflects the change in score between baseline and follow-up.
The researchers found that the CHA2DS2-VASc score remained unchanged in only 40.8 percent of patients. The majority of the 4,103 patients who experienced ischemic stroke had a Delta CHA2DS2-VASc score ≥1 (89.4 percent, versus 54.6 percent in patients without ischemic stroke). Nearly two-thirds of patients who had an ischemic stroke (64.4 percent) had at least one new-onset comorbidity, most commonly hypertension. The Delta CHA2DS2-VASc score significantly better predicted ischemic stroke compared to baseline or follow-up CHA2DS2-VASc scores, based on the C-index and the net reclassification index.
“The Delta CHA2DS2-VASc score, reflecting the change in score between baseline and follow-up, was strongly predictive of ischemic stroke, reflecting how stroke risk in AF is a dynamic process due to increasing age and incident comorbidities,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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