Abstract 17346: The CHADS2 Score Predicts Ischemic Stroke Among Chronic Heart Failure Patients With Sinus Rhythm
Background: The CHADS2 score is useful to stratify the risk of ischemic stroke or transient ischemic attack (TIA)) in patients with non-valvular atrial fibrillation (AF). Chronic heart failure (CHF), as one of the components of the CHADS2 score, is accompanied by a 2- to 3- fold increased risk of stroke. However, it remains unclear whether CHADS2 score could predict ischemic stroke or TIA in CHF patients without AF. Thus, we evaluated the prognostic power of the CHADS2 score for ischemic stroke or TIA in CHF patients without AF.
Methods and Results: In this prospective cohort study we enrolled 125 patients with CHF (LVEF<40%) who didn’t have AF. The CHADS2 score was calculated based on history of CHF, hypertension, age≥75, diabetes, and prior stroke or TIA. The primary endpoint was the incidence of stoke or TIA, determined by blinded review of medical records over 7.5±4.3 years..
Results: The mean baseline CHADS2 score was 2.1±1.0. There were no significant differences in baseline characteristics such as gender, age, NYHA class, left ventricular ejection fraction, anti-coagulation or anti-platelet therapy and anti-heart failure drugs among patients with CHADS2 score 1(low: n=38), score 2(intermediate: n=51), and score 3-6 (high: n=38). During the follow-up period, ischemic stroke or TIA occurred in 19 patients of 126 patients (15.1%). The incidence of ischemic stroke or TIA increased by CHADS2 score (1: 0%, 2: 11.8%, 3-6: 34.2%, p=0.04). Compared to patients with intermediate CHADS2 score, those with high CHADS2 score had significantly higher risk of stroke or TIA (hazard ratio 2.8 95%CI 1.05-7.3, p=0.04).
Conclusion:CHADS2 score could predict ischemic stroke in CHF patients within the absence of AF as well.
- © 2012 by American Heart Association, Inc.