BMC Cardiovascular Disorders, 2019. 19, 193-201, DOI: https://doi.org/10.1186/s12872-019-1178-0

Predicting stroke and death in patients with heart failure using CHA2DS2-VASc score in Asia

Mi Kyoung Son, Nam-Kyoo Lim; Hyun-Young Park

Abstract

Background: The CHA2DS2-VASc score is used to assess risk of mortality as well as to stratify risk of stroke in patientswith atrial fibrillation (AF). This study evaluated whether CHA2DS2-VASc score was predictive of 1 and 2 year risks ofstroke and death in Asian patients with heart failure (HF).

Methods: Patients hospitalized for HF were enrolled in the Korean Acute Heart Failure (KorAHF) registry, a prospectiveobservational multicenter cohort study, between March 2011 and February 2014. Patients with a history of cancerbefore hospitalization for HF were excluded. The discriminatory properties of the CHA2DS2-VASc score were quantifiedusing C-statistics.

Results: The study included 5158 patients with HF, 2091 with and 3067 without AF. Rates of stroke in these twogroups were 4.5 and 2.8%, respectively, after 1 year, and 5.5 and 3.4%, respectively, after 2 years. Each 1-point increasein CHA2DS2-VASc score was associated with significantly increased risks of stroke and all-cause death in HF patientswith and without AF (p-value < 0.05). The C-statistics of the CHA2DS2-VASc score for all-cause death in patients withand without AF were 0.600 and 0.630, respectively, at 1 year and 0.626 and 0.635, respectively, at 2 years. The C-statisticsfor stroke ranged from 0.593 to 0.639.

Conclusions: Among patients with incident HF with and without AF, CHA2DS2-VASc score was significantly associatedwith the risks of stroke and death. However, CHA2DS2-VASc score was only a modest predictor of stroke and death,indicating the need for studies evaluating modified CHA2DS2-VASc scores. The majority of strokes occurred relativelyshortly after hospitalization for HF and that mortality rates in patients with HF remain high. Thus, early treatment afterHF to prevent stroke is essential.

• DOI: https://doi.org/10.1186/s12872-019-1178-0
• ISBN or ISSN: 1471-2261

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.