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Background The CHA 2 DS 2-VASc schema has recently been introduced to complement the CHADS2 score and improve the identification of atrial fibrillation (AF) patients at ’truly low risk’ for thromboembolism.We tested the predictive ability of the CHA 2 DS 2-VASc,CHADS2 and van Walraven risk stratification schemes in a cohort of ’lone’ AF patients with a 12-year follow-up.Methods and Results We conducted a registry-based,observational cohort study of 345 patients initially diagnosed with ’lone’ AF between 1992 and 2007.At baseline,all patients had the CHADS2 and van Walraven scores of 0,and 262 (75.9%) had a CHA 2 DS 2VASc score=0.During follow-up (or within a year prior to stroke),228 (66.1%),234 (67.8%) and 150 patients (43.5%) retained the CHADS2,van Walraven and CHA 2 DS 2VASc scores of 0,respectively.The overall rate of ischemic stroke was 0.19 (95%CI:0.18-0.20) per 100 patient-years.In the multivariable analysis,only the CHA 2 DS 2-VASc score of 0 was significantly related to the absence of stroke (OR 5.1,95%CI:1.5-16.8,P=0.008).Only the CHA 2 DS 2-VASc score had a significant prediction ability (c-statistic 0.72 [0.61-0.84],P=0.031).Conclusions The CHA 2 DS 2-VASc score reliably identified the ’lone’ AF patients who were at ’truly low risk’ for thromboembolism,and was the only tested risk stratification scheme with a significant predictive ability for thromboembolism amongst lone AF patients.
Background The CHA 2 DS 2-VASc schema has recently been introduced to complement the CHADS2 score and improve the identification of atrial fibrillation (AF) patients at ’truly low risk’ for thromboembolism. We tested the predictive ability of the CHA 2 DS 2- VASc, CHADS2 and van Walraven risk stratification schemes in a cohort of ’lone’ AF patients with a 12-year follow-up. Methods and Results We conducted a registry-based, observational cohort study of 345 patients initially diagnosed with ’lone’ AF between 1992 and 2007. At baseline, all patients had the CHADS2 and van Walraven scores of 0, and 262 (75.9%) had a CHA2 DS2VASc score = 0. Fluid follow-up (or within a year prior to stroke), 228 (66.1%), 234 (67.8%), and 150 patients (43.5%) retained the CHADS2, van Walraven and CHA 2 DS 2VASc scores of 0, respectively.The overall rate of ischemic stroke was 0.19 (95% CI: 0.18- 0.20) per 100 patients- years. In the multivariable analysis, only the CHA 2 DS 2-VASc score of 0 was significantly related to the a In situ CHA 2 DS 2-VASc score had a significant predictive ability (c-statistic 0.72 [0.61-0.84], P = 0.031), bsence of stroke (OR 5.1,95% CI: 1.5-16.8, P = 0.008). Conclusions The CHA 2 DS 2-VASc scores reliably identified the ’lone’ AF patients who were at ’truly low risk’ for thromboembolism, and was the only tested risk stratification scheme with a significant predictive ability for thromboembolism amongst lone AF patients.