Abstract WP333: A Simplified Score to Predict Stroke Risk in Nonvalvular Atrial Fibrillation
The widely used CHADS2 score has been validated to predict the annual stroke risk (SR) in patients with non-valvular atrial fibrillation (AF). The CHA2DS2-VASc score incorporates 5 more risk factors including female gender, age 65 to 74 years, and peripheral arterial disease (PAD), prior myocardial infarct or aortic plaque. The two schemes have different SR and require separate tables to calculate SR (Table 1).
Table 1 An acronym (AFIB)2S4+PaF2 (Table 2) is presented to predict SR that increases with higher scores, simplifies memorization of the score, incorporates all known risk factors and more accurately predicts SR without the use of tables.
Table 2 The SR per 100 patient-years is calculated by adding (AFIB)2S4+PaF2 scores. For example if all are positive including age 75 years then the SR is 15%, while if all are negative, including age <65 and male gender, then the SR is 0.
To determine the predictive accuracy of the three scores, we reviewed the records of 100 consecutive patients admitted with acute cerebrovascular events and AF. The results showed 83% would have been classified as moderate to high risk (score>1) by CHADS2, 95% by CHA2DS2-VASc, and 99% by (AFIB)2S4+PaF2. (P <0.012).
Conclusion: Compared to the CHADS2, and CHA2DS2-VASc, (AFIB)2S4+PaF2 more accurately predicts risk of acute cerebrovascular events in patients with AF.
It is easy to remember and does not require the use of tables to assess SR in AF. Further studies are needed for validation.
- © 2012 by American Heart Association, Inc.