Modified CHADS2 and CHA2DS2-VASc scores to predict atrial fibrillation in acute ischemic stroke patients.

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Modified CHADS2 and CHA2DS2-VASc scores to predict atrial fibrillation in acute ischemic stroke patients.

J Clin Neurosci. 2018 Feb 23;:

Authors: Liu R, Yang X, Li S, Jiang Y, Wang Y, Wang Y

Abstract
It is important to identify candidates who warrant extended cardiac monitoring after ischemic stroke. We investigated the predictive performance of the CHADS2 and CHA2DS2-VASc scores for previously unknown atrial fibrillation during in-hospital electrocardiographic monitoring. Patients were selected from a prospective trial in China. The clinical prediction of the scores was examined using the C statistic. Multivariate logistic regressions were performed to analyze the relevant risk factors. Among 1315 patients enrolled in study, previously unknown atrial fibrillation was detected in 110 (8.4%). Age, heart failure, NIHSS on admission, creatinine, and triglycerides were independently associated with newly detected atrial fibrillation. For newly detected atrial fibrillation, the C statistic value was 0.55 (OR 1.14, 95% CI: 0.97-1.33) for CHADS2 and 0.62 (OR 1.26, 95% CI: 1.12-1.42) for CHA2DS2-VASc; adding newly identified risk factors to these two scores, the value of C statistic was improved to 0.74 and 0.75, respectively. Age, heart failure, NIHSS on admission, creatinine and triglycerides were independent predictors of previously unknown atrial fibrillation. The CHADS2 and CHA2DS2-VASc scores are useful but not optimal for atrial fibrillation prediction. Addition of newly identified risk factors to these two scores resulted in significant improvement of the predictive performance.

PMID: 29483010 [PubMed - as supplied by publisher]

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