Can CHADS2 Score Predict CV Risk, Mortality Among Patients Without AFib?

Baseline CHADS₂ score is an independent risk factor for cardiovascular (CV) events and all-cause mortality among patients without atrial fibrillation (AF), according to findings of a new study.

“The association between CHADS₂ score and stroke has been confirmed in patients with [AF]. But the majority of [CV] events occurred primarily in [the] population without [AF],” the researchers wrote. “Therefore, we performed this cohort study to evaluate the association between baseline CHADS₂ score and [CV] events in the population without [AF].” 

For up to 10 years, the researchers followed 99,755 adults from China who had complete baseline data. In turn, it was determined that the incidence of CV events (myocardial infarction [MI], cerebral infarction, or cerebral hemorrhage) and all-cause mortality had increased with CHADS₂ score.

In fact, after adjusting for age, gender, and other conventional CV confounders, each 1-point increase in CHADS₂ score was associated with the risk of all the outcomes.

The area under the receiver operating characteristic curve was calculated for each kind of outcome. Results were as follows:

• MI, 0.66
• Cerebral infarction, 0.67
• Cerebral hemorrhage, 0.66
• CV events, 0.67
• All-cause mortality, 0.69

The hazard ratio (95% confidence interval) was 1.17 (1.13-1.22) for CV event and 1.12 (1.08-1.15) for all-cause mortality.

—Colleen Murphy

Reference:

Ji C, Wu S, Shi J, et al. Baseline CHADS2 score and risk of cardiovascular events in the population without atrial fibrillation. Am J Cardiol. Published online June 3, 2020. doi:10.1016/j.amjcard.2020.05.035