Added predictive ability of the cha2ds2vasc risk score for stroke and death in patients with atrial fibrillation: the prospective danish diet, cancer, and health cohort study
Circulation: Cardiovascular Quality and Outcomes,

Larsen TB et al. – Both the CHADS2 as well as the CHA2DS2VASc risk score can exclude a large proportion of patients from having high risk of stroke or death. However, using the CHA2DS2VASc risk score, fewer patients will fulfill the criterion for low risk (and are truly low risk for thromboembolism). For every 10 extra patients transferred to the treatment group at 5 years, using the CHA2DS2VASc risk score, 1 patient would have had a stroke that might have been avoided with effective treatment.

Methods
  • Authors included 1603 nonanticoagulated patients with incident atrial fibrillation from a Danish prospective cohort study of 57 053 middle-aged men and women.
  • The Net Reclassification Improvement was calculated as a measure to estimate any overall improvement in reclassification with the CHA2DS2VASc sore as an alternative to the CHADS2 score.
  • After 1-year follow-up, crude incidence rates were 3.4 per 100 person-years for stroke and 13.6 for death.
  • After a mean follow-up of 5.4 years (±3.7 years), the crude incidence rates for stroke and death were 1.9 and 5.6, respectively.

Results
  • During the entire observation period, the c-statistics and negative predictive values were similar for both risk scores.
  • The Net Reclassification Improvement analysis showed that 1 of 10 reclassified atrial fibrillation patients would have been upgraded correctly using the CHA2DS2VASc score.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Physician Assistant

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Physician Assistant Articles

1 Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): A randomised, multicentre, open-label, phase 3 non-inferiority trial The Lancet Oncology, October 22, 2014    Clinical Article

2 Dance for Parkinson's: A new framework for research on its physical, mental, emotional, and social benefits Complementary Therapies in Medicine, June 17, 2014    Review Article

3 Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review Clinical Nutrition, November 21, 2014    Clinical Article

4 Global burden of cancer attributable to high body-mass index in 2012: A population-based study The Lancet Oncology, November 26, 2014    Clinical Article

5 Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents New England Journal of Medicine, November 18, 2014    Evidence Based Medicine    Clinical Article

6 Nonobstructive coronary artery disease and risk of myocardial infarction JAMA, November 6, 2014    Evidence Based Medicine    Clinical Article

7 Treatment of syphilis: a systematic review JAMA, November 13, 2014    Review Article    Clinical Article

8 Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial The Lancet, November 26, 2014    Evidence Based Medicine    Clinical Article

9 Effects of salt substitutes on blood pressure: A meta-analysis of randomized controlled trials American Journal of Clinical Nutrition, October 31, 2014    Evidence Based Medicine    Review Article    Clinical Article

10 Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period The Lancet, November 19, 2014    Evidence Based Medicine

11 Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial The Lancet, November 26, 2014    Clinical Article

12 Initial choice of oral glucose-lowering medication for diabetes mellitus: a patient-centered comparative effectiveness study JAMA Internal Medicine, November 14, 2014    Evidence Based Medicine    Clinical Article

13 Optimization of rituximab for the treatment of diffuse large B-cell lymphoma (II): extended rituximab exposure time in the smarte-R-CHOP-14 trial of the German High-grade Non-hodgkin Lymphoma Study Group Journal of Clinical Oncology, November 26, 2014    Clinical Article

14 Early versus on-demand nasoenteric tube feeding in acute pancreatitis New England Journal of Medicine, November 26, 2014    Evidence Based Medicine    Clinical Article

15 Ventriculitis caused by primary T-cell CNS lymphoma in an immunocompetent patient Journal of Clinical Oncology, November 26, 2014

16 Long-term safety and efficacy of factor IX gene therapy in hemophilia B New England Journal of Medicine, November 26, 2014    Evidence Based Medicine    Clinical Article

17 Management of high-grade gliomas in the elderly Seminars in Radiation Oncology, October 3, 2014    Clinical Article

18 The diagnosis and management of hiatus hernia BMJ, November 14, 2014    Evidence Based Medicine    Review Article    Clinical Article

19 Statins in the elderly: an answered question Current Opinion in Cardiology, June 9, 2014    Evidence Based Medicine    Review Article    Clinical Article

20 Changes in bone mineral density at 3 years in postmenopausal women receiving anastrozole and risedronate in the IBIS-II bone substudy: An international, double-blind, randomised, placebo-controlled trial The Lancet Oncology, November 26, 2014    Clinical Article

Indexed Journals in Physician Assistant: Advance for Physicians Assistants, American Family Physicianmore