CHADS2 and CHA2DS2-VASc scores are independently associated with incident atrial fibrillation: the Catanzaro Atrial Fibrillation Project

Intern Emerg Med. 2015 Oct;10(7):815-21. doi: 10.1007/s11739-015-1243-3. Epub 2015 May 5.

Abstract

No data exist concerning a possible association between CHADS2 or CHA2DS2-VASc scores and atrial fibrillation (AF). In this prospective observational study, we tested the hypothesis whether thromboembolic risk scores predict AF. We investigated 3549 subjects, 1829 men and 1720 women, aged 60.7 ± 10.6 years, without baseline AF. Patients with thyroid disorders were excluded. CHADS2 and CHA2DS2-VASc scores were evaluated as categorical variables. To test the effect of some clinical confounders on incident AF, we constructed different models including clinical and laboratory parameters. During follow-up (53.3 ± 18.1 months), 546 subjects developed AF (4.5 events/100 patient-years). Progressors to AF are older, have a higher body mass index (BMI), blood pressure, LDL-cholesterol, and glucose. Hypertension, metabolic syndrome, diabetes and carotid wall thickening were more common among AF cases than among control subjects. In the final Cox-regression model, variables that remained significantly associated with incident AF were BMI (HR = 1.022, 95% CI = 1.008-1.037), LDL-cholesterol (HR = 1.032, 95% CI = 1.008-1.056), CHA2DS2-VASc score (HR = 1.914, 95% CI = 1.439-2.546), and CHADS2 score (HR = 2.077, 95% CI = 1.712-2.521). In conclusion, CHADS2 and CHA2DS2-VASc scores are independent predictors of AF.

Keywords: Atrial fibrillation; CHA2DS2-VASc score; CHADS2 score; Cardiovascular risk factors.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / etiology*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / mortality
  • Female
  • Heart Failure / complications
  • Heart Failure / mortality
  • Humans
  • Hypertension / complications
  • Hypertension / mortality
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / mortality
  • Male
  • Middle Aged
  • Proportional Hazards Models*
  • Prospective Studies
  • Risk Factors
  • Stroke / complications
  • Stroke / mortality
  • Vascular Diseases / complications
  • Vascular Diseases / mortality