• Eur. J. Clin. Invest. · Jun 2019

    Predicting stroke in patients without atrial fibrillation.

    • Kamilla Steensig, Kevin K W Olesen, Troels Thim, Jens C Nielsen, Morten Madsen, Svend E Jensen, Lisette O Jensen, Steen D Kristensen, LipGregory Y HGYHLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., and Michael Maeng.
    • Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
    • Eur. J. Clin. Invest. 2019 Jun 1; 49 (6): e13103e13103.

    BackgroundOnly few studies in selected cohorts have examined whether the CHA2 DS2 -VASc score can predict the risk of atrial fibrillation and thromboembolic events in patients without atrial fibrillation.Materials And MethodsPatients with coronary angiography performed between 2004 and 2012 were grouped according to CHA2 DS2 -VASc score. We excluded patients with atrial fibrillation, anticoagulant therapy and follow-up <30 days. The endpoints were atrial fibrillation and a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. Event rates per 100 person-years were estimated for each CHA2 DS2 -VASc score (0, 1, 2, 3, 4, and >4). Incidence rate ratios were calculated using low-risk patients (CHA2 DS2 -VASc score 0 in males or 1 in females) as reference.ResultsIn total, 78 233 patients were included with group sizes varying between 8299 (CHA2 DS2 -VASc >4) and 19 882 (CHA2 DS2 -VASc 2). An increasing CHA2 DS2 -VASc score was significantly associated with a future diagnosis of atrial fibrillation (P for trend <0.0001) and an incremental risk of ischaemic stroke, transient ischaemic attack, systemic embolism (P for trend <0.0001) and all-cause death (P for trend <0.0001). Patients with a CHA2 DS2 -VASc score of 3 had a rate of ischaemic stroke/transient ischaemic attack/systemic embolism of 1.30 per 100 person-years.ConclusionsAmong patients undergoing coronary angiography, the CHA2 DS2 -VASc score predicted a future diagnosis of atrial fibrillation and the composite risk of ischaemic stroke, transient ischaemic attack or systemic embolism in patients without atrial fibrillation. A CHA2 DS2 -VASc score of 3 was associated with a risk that would justify prophylactic oral anticoagulation treatment in a patient with atrial fibrillation.© 2019 Stichting European Society for Clinical Investigation Journal Foundation.

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