Open AccessThe CHA 2 DS 2 ‐VASc score as a predictor of high mortality in hospitalized heart failure patients
Author(s) -
Yoshihisa Akiomi,
Watanabe Shunsuke,
Kanno Yuki,
Takiguchi Mai,
Sato Akihiko,
Yokokawa Tetsuro,
Miura Shunsuke,
Shimizu Takeshi,
Abe Satoshi,
Sato Takamasa,
Suzuki Satoshi,
Oikawa Masayoshi,
Sakamoto Nobuo,
Yamaki Takayoshi,
Sugimoto Koichi,
Kunii Hiroyuki,
Nakazato Kazuhiko,
Suzuki Hitoshi,
Saitoh Shuichi,
Takeishi Yasuchika
Publication year - 2016
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12098
Subject(s) - medicine , heart failure , atrial fibrillation , hazard ratio , cha2ds2–vasc score , ejection fraction , cardiology , stroke (engine) , proportional hazards model , framingham risk score , ischemic stroke , confidence interval , disease , mechanical engineering , ischemia , engineering
Aims Atrial fibrillation (AF) is common in patients with heart failure (HF). CHA 2 DS 2 ‐VASc score was originally employed as a risk assessment tool for stroke in patients with AF; however, it has recently been used to predict not only stroke but also various cardiovascular diseases beyond the original AF field. We aimed to verify the CHA 2 DS 2 ‐VASc score as a risk assessment tool to predict mortality in patients with HF. Methods and Results Consecutive 1011 patients admitted for treatment of HF were divided into three groups based on their CHA 2 DS 2 ‐VASc scores: score 1–3 group ( n = 317), score 4–6 group ( n = 549) and score 7–9 group ( n = 145). Of the 1011 HF patients, 387 (38.3%) had AF. We compared patient characteristics among the three groups and prospectively followed for all‐cause mortality. Although left ventricular ejection fraction was similar among all three groups, all‐cause mortality was higher in the score 4–6 group and score 7–9 group than in the score 1–3 group (37.9 and 29.3% vs. 15.1%, log‐rank P < 0.001). In the multivariable Cox proportional hazard analysis, the CHA 2 DS 2 ‐VASc score 7–9 was an independent predictor of all‐cause mortality (all HF patients: hazard ratio (HR) 1.822, P = 0.011; HF patients with AF: HR 1.951, P = 0.031; HF patients without AF: HR 2.215, P = 0.033). Conclusions The CHA 2 DS 2 ‐VASc score was an independent predictor of all‐cause mortality in HF patients with or without AF. This comprehensive risk assessment score may help identify HF patients who are at high risk for mortality in HF patient.