Abstract 16181: CHADS2 and CHA2DS2-VASc Scores in the Prediction of Thromboembolism Events in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Stenting
Objectives: Atrial fibrillation (AF) is associated with increased risk of thromboembolism events (TE). However, limited data are available on the predictors of TE in patients with AF undergoing percutaneous coronary artery stenting. So we evaluate whether CHADS2 and CHA2DS2-VASc scores are adequate for TE risk stratification in patients with AF after stent implantation.
Methods: We reviewed consecutive 634 patients with AF treated with at least one stent implanted between January 2007 and July 2011, who were taking dual antiplatelet therapy (without warfarin) at discharge. The main outcome endpoint was occurrence of TE (ischemic stroke, transient ischemic attack, peripheral embolism, or pulmonary embolisms) during follow-up.
Results: Complete follow-up was achieved in 89.4% of the cohort. During a follow-up of 35.64±16.65months, 52 patients (2.6 per 100 person-years) experienced TE. CHA2DS2-VASc score was significant predictor of TE in multivariate models (HR 1.247, 95%CI 1.059-1.468, p=0.008), while CHADS2 wasn’t (HR 1.168, 95%CI 0.935-1.459, p=0.171). The areas under the receiver-operator characteristic curves based on the CHADS2 and CHA2DS2-VASc scores in predicting events were 0.553 and 0.610 (P=0.014). In addition, among patients with CHADS2 scores of 0 or 1 (n=344), CHA2DS2-VASc scores were useful to further identify which patients were predisposed to adverse events at a cutoff value of 2 (2.8% vs. 10.2%, p=0.022).
Conclusions: The CHA2DS2-VASc score was better than CHADS2 score in predicting of TE in patients with AF undergoing percutaneous coronary artery stenting, for the former was helpful in further risk stratifications among patients with CHADS2 scores of 0 or 1.
- © 2013 by American Heart Association, Inc.