Volume 13, Issue 1, Pages (January 2016)

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Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Gastrointestinal Bleeding in Patients With Atrial.

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Volume 13, Issue 1, Pages 46-53 (January 2016) Comparisons of CHADS2 and CHA2DS2-VASc scores for stroke risk stratification in atrial fibrillation: Which scoring system should be used for Asians? Tze-Fan Chao, MD, Chia-Jen Liu, MD, Ta-Chuan Tuan, MD, Su-Jung Chen, MD, Kang-Ling Wang, MD, Yenn-Jiang Lin, MD, Shih-Lin Chang, MD, Li-Wei Lo, MD, Yu-Feng Hu, MD, Tzeng-Ji Chen, MD, Chern-En Chiang, MD, PhD, Shih-Ann Chen, MD Heart Rhythm Volume 13, Issue 1, Pages 46-53 (January 2016) DOI: 10.1016/j.hrthm.2015.08.017 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Distributions of CHADS2 and CHA2DS2-VASc scores of the study cohort. The percentages of patients with a score of 0 were 13.6% for CHADS2 and 5.1% for CHA2DS2-VASc. There were 65.7% of patients having a CHADS2 score ≥2 and 84.5% having a CHA2DS2-VASc score ≥2. AF = atrial fibrillation. Heart Rhythm 2016 13, 46-53DOI: (10.1016/j.hrthm.2015.08.017) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 ROC curves of CHADS2 and CHA2DS2-VASc scores in predicting ischemic stroke. The c-indexes based on the areas under the curves (AUC) for the CHADS2 and CHA2DS2-VASc scores in predicting ischemic stroke were 0.659 and 0.698, respectively (DeLong test, P <.0001). ROC = receiver operating characteristic. Heart Rhythm 2016 13, 46-53DOI: (10.1016/j.hrthm.2015.08.017) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Kaplan–Meier curves of atrial fibrillation patients with a CHADS2 score of 0 stratified based on CHA2DS2-VASc scores. Among 25,286 patients with a CHADS2 score of 0, the rate of ischemic stroke differed significantly among patients with a CHA2DS2-VASc score of 0–3. Heart Rhythm 2016 13, 46-53DOI: (10.1016/j.hrthm.2015.08.017) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 4 Annual risk and hazard ratios of ischemic stroke in patients with a CHADS2 score of 0 stratified based on CHA2DS2-VASc scores. A: Among 25,286 patients with a CHADS2 score of 0, the annual rate of ischemic stroke ranged from 1.15% for patients with a CHA2DS2-VASc score of 0, to 4.47% for patients with a CHA2DS2-VASc score of 3. B: The hazard ratios of ischemic stroke continuously increased for patients with a CHA2DS2-VASc score of 1 to 3 compared to those with a CHA2DS2-VASc score of 0. AF = atrial fibrillation; CI = confidence interval. Heart Rhythm 2016 13, 46-53DOI: (10.1016/j.hrthm.2015.08.017) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 5 Risk of ischemic stroke stratified by CHADS2 (A) and CHA2DS2-VASc (B) scores for Chinese and Caucasians. Chinese atrial fibrillation (AF) patients with a CHADS2 or CHA2DS2-VASc score ≤2 had a higher risk of ischemic stroke compared to Caucasians. However, at a higher CHADS2 and CHA2DS2-VASc score (≥3), the stroke risk in Chinese was comparable or lower than that of Caucasians. CI = confidence interval. (The risk of ischemic stroke for Caucasians was based on data from U.S. Medicare clams2 and a Danish cohort.4) Heart Rhythm 2016 13, 46-53DOI: (10.1016/j.hrthm.2015.08.017) Copyright © 2016 Heart Rhythm Society Terms and Conditions