Featured Research

from universities, journals, and other organizations

CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk

Date:
August 31, 2013
Source:
European Society of Cardiology
Summary:
The CHADS2 stroke risk scores 0 or 1 assign more than one-third of patients in atrial fibrillation with stroke to low or intermediate risk not mandating oral anticoagulation, according to new research.

The CHADS2 stroke risk scores 0 or 1 assign more than one-third of patients in atrial fibrillation with stroke to low or intermediate risk not mandating oral anticoagulation, according to research presented at ESC Congress 2013 today by Professor Michael Nabauer from Germany.

In contrast, a CHA2DS2-VASc score of 0 identifies a subgroup of patients with very low stroke risk unlikely to benefit from anticoagulation treatment.

Professor Nabauer said: "AF is the most frequent cardiac arrhythmia requiring hospitalisation and has a 1-2% prevalence in the general population. AF is associated with a significant risk of stroke with frequently disabling consequences. While oral anticoagulation is very effective in preventing ischaemic strokes in AF, it increases bleeding risk. Identification of patients with low risk of stroke not requiring oral anticoagulation is important to maximise anticoagulation benefit while avoiding the cost, hassle, and bleeding risk of oral anticoagulation."

The present study tested stroke risk stratification schemes for identifying patients with very low stroke risk who may not benefit from oral anticoagulation. The analysis was based on the prospective registry of the German Competence Network on Atrial Fibrillation (AFNET) which started in 2004-2006 and includes 9,575 patients with AF. Follow-up was for a mean of 5.1 years, and stroke events were adjudicated by a critical event committee.

On enrolment, 47.7% of patients with non-valvular AF (n=8,847) in the AFNET registry were assigned a CHADS2 score of 0 (16.2%) or 1 (31.5%) indicating that oral anticoagulation was not definitively recommended. Surprisingly, 35.8% (145 out of 405) of strokes and other thromboembolic events (transient ischaemic attack, systemic embolism) during follow-up occurred in this patient subgroup initially classified by CHADS2 to have low or intermediate stroke risk (CHADS2=0: 45, CHADS2=1: 100 events).

Professor Nabauer said: "This finding suggests that classes CHADS2 0 and 1 contain subgroups of patients with significant stroke risk that may be identified by refined stroke risk stratification."

The CHA2DS2-VASc score, which adds age 65-74 years, vascular disease and female gender as stroke risk factors to the CHADS2 score, has been put forward to improve risk stratification in patients with low stroke risk and is the recommended risk stratification scheme in the ESC Guidelines on atrial fibrillation.

In the current study, application of the CHA2DS2-VASc score reclassified 53.8% of patients with CHADS2 scores 0 or 1 to a CHA2DS2-VASc score of 2 and higher, where oral anticoagulation is the recommended treatment. Conversely, CHA2DS2-VASc assigned a very low stroke risk score of 0 to 55.6% of patients previously classified as CHADS2=0 (9.0% of all patients).

Professor Nabauer said: "Only 8 strokes and other thromboembolic events were observed in these patients classified as CHA2DS2-VASc=0 during the follow-up period (strokes occurring in association with cardioversion or ablation were excluded). This finding supports the use of CHA2DS2-VASc stroke risk stratification to identify patients at very low stroke risk who may not benefit from oral anticoagulation for ischaemic stroke prevention."

He concluded: "A CHADS2 score of 0 or 1 does not appear to be suitable to identify patients with AF at low risk for stroke while CHA2DS2-VASc picks up these patients. The risk of stroke in patients with a CHA2DS2-VASc score of 0 over a mean follow up of 5.1 years was very low. Our data support the current recommendation that oral anticoagulation is not beneficial in patients with 'lone AF' or a CHA2DS2-VASc score of 0."


Story Source:

The above story is based on materials provided by European Society of Cardiology. Note: Materials may be edited for content and length.


Cite This Page:

European Society of Cardiology. "CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk." ScienceDaily. ScienceDaily, 31 August 2013. <www.sciencedaily.com/releases/2013/08/130831110913.htm>.
European Society of Cardiology. (2013, August 31). CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk. ScienceDaily. Retrieved August 27, 2014 from www.sciencedaily.com/releases/2013/08/130831110913.htm
European Society of Cardiology. "CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk." ScienceDaily. www.sciencedaily.com/releases/2013/08/130831110913.htm (accessed August 27, 2014).

Share This




More Health & Medicine News

Wednesday, August 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

WHO Calls for Ban on E-Cigarette Sales to Minors

WHO Calls for Ban on E-Cigarette Sales to Minors

AFP (Aug. 26, 2014) The World Health Organization called Tuesday on governments should ban the sale of e-cigarettes to minors, warning that they pose a "serious threat" to foetuses and young people. Duration: 01:44 Video provided by AFP
Powered by NewsLook.com
Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Newsy (Aug. 26, 2014) A study published in the journal "Neurology" interviewed more than 19,000 people and found 15 percent suffer from being "sleep drunk." Video provided by Newsy
Powered by NewsLook.com
Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Newsy (Aug. 26, 2014) A new study found fewer deaths from prescription drug overdoses in states that have legalized medical marijuana. But experts disagree on the results. Video provided by Newsy
Powered by NewsLook.com
Official: British Ebola Sufferer Receiving Experimental Drug

Official: British Ebola Sufferer Receiving Experimental Drug

AFP (Aug. 26, 2014) A British nurse infected with Ebola while working in Sierra Leone is being given the same experimental drug used on two US missionaries who have recovered for the disease, doctors in London say. Duration: 00:44 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins