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CHA 2 DS 2 VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation
Author(s) -
POLENZ GUSTAVO FREB,
LEIRIA TIAGO LUIZ LUZ,
ESSEBAG VIDAL,
KRUSE MARCELO LAPA,
PIRES LEONARDO MARTINS,
NOGUEIRA THAIZE BRISOLARA,
GUIMARÃES RAPHAEL BOESCHE,
SANTANNA ROBERTO TOFANI,
DE LIMA GUSTAVO GLOTZ
Publication year - 2015
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12744
Subject(s) - medicine , atrial fibrillation , stroke (engine) , heart failure , incidence (geometry) , diabetes mellitus , cardiology , ambulatory , adverse effect , prospective cohort study , cohort , atrial flutter , confidence interval , mechanical engineering , physics , endocrinology , optics , engineering
Background New evidence suggests that the CHA 2 DS 2 VASc (congestive heart failure, hypertension [HTN], age, diabetes, stroke, vascular disease, and female gender) score may be a reliable tool to predict the risk of thromboembolic events in patients without documented atrial fibrillation (AF). Methods We performed a prospective cohort study of outpatients without AF or flutter, who were not using oral anticoagulation. Clinical characteristics were assessed and patients were stratified according to the CHA 2 DS 2 VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA 2 DS 2 VASc score during the follow‐up. Results Four hundred sixty‐eight patients without AF were enrolled with a mean follow‐up of 12 ± 6 months. Age was 64.9 ± 11.3 years. The prevalence of HTN was 88.4%, diabetes 37.6%, heart failure 26.3%, and vascular disease 61.7%. Overall, CHA 2 DS 2 VASc score was 3.4 ± 1.4. There were 15 major adverse cardiac outcomes during 12.2 months of follow‐up (overall incidence of 3.2 per 100 person‐years). We found significant differences in relation to gender, age, previous stroke, and follow‐up length in patients with and without adverse outcomes. The CHA 2 DS 2 VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA 2 DS 2 VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27–13.90). Conclusions In our population, CHA 2 DS 2 VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF.