NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].
Show detailsBibliographic details: Chen JY, Zhang AD, Lu HY, Guo J, Wang FF, Li ZC. CHADS2 versus CHA2DS2-VASc score in assessing the stroke and thromboembolism risk stratification in patients with atrial fibrillation: a systematic review and meta-analysis. Journal of Geriatric Cardiology 2013; 10(3): 258-266. [PMC free article: PMC3796700] [PubMed: 24133514]
Abstract
OBJECTIVE: To perform a systematic review and meta-analysis of the predictive abilities of CHADS2 and CHA2DS2-VASc in stroke and thromboembolism risk stratification of atrial fibrillation (AF) patients.
METHODS: We searched PubMed and EMBASE for English-language literature on comparisons of the diagnostic performance between CHADS2 and CHA2DS2-VASc in predicting stroke, or systemic embolism, in AF. We then assessed the quality of the included studies and pooled the C-statistics and 95% confidence intervals (95% CI).
RESULTS: Eight studies were included. It was unsuitable to perform a direct meta-analysis because of high heterogeneity. When analyzed as a continuous variable, the C-statistic ranged from 0.60 to 0.80 (median 0.683) for CHADS2 and 0.64-0.79 (median 0.673) for CHA2DS2-VASc. When analyzed as a continuous variable in anticoagulation patients, the subgroup analysis showed that the pooled C-statistic (95% CI) was 0.660 (0.655-0.665) for CHADS2 and 0.667 (0.651-0.683) for CHA2DS2-VASc (no significant difference). For non-anticoagulation patients, the pooled C-statistic (95% CI) was 0.685 (0.666-0.705) for CHADS2 and 0.675 (0.656-0.694) for CHA2DS2-VASc (no significant difference). The average ratio of endpoint events in the low-risk group of CHA2DS2-VASc was less than CHADS2 (0.41% vs. 0.94%, P < 0.05). The average proportion of the moderate-risk group of CHA2DS2-VASc was lower than CHADS2 (11.12% vs. 30.75%, P < 0.05).
CONCLUSIONS: The C-statistic suggests a similar clinical utility of the CHADS2 and CHA2DS2-VASc scores in predicting stroke and thromboembolism, but CHA2DS2- VASc has the important advantage of identifying extremely low-risk patients with atrial fibrillation, as well as classifying a lower proportion of patients as moderate risk.
- Predictive role of CHADS2 and CHA2DS2-VASc scores on stroke and thromboembolism in patients without atrial fibrillation: a meta-analysis.[Ann Med. 2016]Predictive role of CHADS2 and CHA2DS2-VASc scores on stroke and thromboembolism in patients without atrial fibrillation: a meta-analysis.Liu FD, Shen XL, Zhao R, Li GF, Wu YL, Tao XX, Wang S, Zhou JJ, Zheng B, Zhang QT, et al. Ann Med. 2016 Aug; 48(5):367-75. Epub 2016 May 6.
- Review Meta-analysis of CHADS2 versus CHA2DS2-VASc for predicting stroke and thromboembolism in atrial fibrillation patients independent of anticoagulation.[Tex Heart Inst J. 2015]Review Meta-analysis of CHADS2 versus CHA2DS2-VASc for predicting stroke and thromboembolism in atrial fibrillation patients independent of anticoagulation.Zhu WG, Xiong QM, Hong K. Tex Heart Inst J. 2015 Feb; 42(1):6-15. Epub 2015 Feb 1.
- Renal dysfunction, stroke risk scores (CHADS2, CHA2DS2-VASc, and R2CHADS2), and the risk of thromboembolic events after catheter ablation of atrial fibrillation: the Leipzig Heart Center AF Ablation Registry.[Circ Arrhythm Electrophysiol. ...]Renal dysfunction, stroke risk scores (CHADS2, CHA2DS2-VASc, and R2CHADS2), and the risk of thromboembolic events after catheter ablation of atrial fibrillation: the Leipzig Heart Center AF Ablation Registry.Kornej J, Hindricks G, Kosiuk J, Arya A, Sommer P, Husser D, Rolf S, Richter S, Piorkowski C, Gaspar T, et al. Circ Arrhythm Electrophysiol. 2013 Oct; 6(5):868-74. Epub 2013 Sep 18.
- The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study.[Thromb Haemost. 2012]The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study.Olesen JB, Torp-Pedersen C, Hansen ML, Lip GY. Thromb Haemost. 2012 Jun; 107(6):1172-9. Epub 2012 Apr 3.
- Review Stroke Prevention in Atrial Fibrillation[ 2013]Review Stroke Prevention in Atrial FibrillationLopes RD, Crowley MJ, Shah BR, Melloni C, Wood KA, Chatterjee R, Povsic TJ, Dupre ME, Kong DF, de Barros e Silva PGM, et al. 2013 Aug
- CHADS2 versus CHA2DS2-VASc score in assessing the stroke and thromboembolism ris...CHADS2 versus CHA2DS2-VASc score in assessing the stroke and thromboembolism risk stratification in patients with atrial fibrillation: a systematic review and meta-analysis - Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews
Your browsing activity is empty.
Activity recording is turned off.
See more...