CHADS₂ score has a better predictive value than CHA₂DS₂-VASc score in elderly patients with atrial fibrillation

Figures & data

Table 1 Baseline characteristics of patients with AF by CHADS₂ scores

Variable	Total (n=413)	CHADS2 score 0 (n=7)	CHADS2 score 1 (n=42)	CHADS2 score ≥2 (n=364)	P-value
Age (years), mean ± standard deviation	80.82±7.34	68.29±2.81	73.90±7.46a	81.87±6.71a	0.000
Components of CHA2DS2-VASc, n (%)
Cardiac failure	99 (24.0)	0 (0)	2 (4.8)a	97 (26.7)a,b	0.015
Hypertension	320 (77.5)	0 (0)	20 (47.6)a	300 (82.4)a,b	0.000
≥75 years	343 (83.1)	0 (0)	15 (35.7)a	328 (90.1)a,b	0.000
DM	149 (36.1)	0 (0)	5 (11.9)a	144 (39.6)a,b	0.000
Previous stroke/TIA	152 (36.8)	0 (0)	0 (0)a	152 (41.8)a,b	0.000
Vascular disease	221 (53.5)	1 (14.3)	18 (42.9)a	202 (55.5)a	0.033
65–74 years	70 (16.9)	7 (100)	27 (64.3)a	36 (9.9)a,b	0.000
Sex category (female)	119 (28.8)	1 (14.3)	19 (45.2)a	99 (27.2)a,b	0.035
Antiplatelet	282 (68.3)	5 (71.4)	30 (71.4)	247 (67.9)	0.630
CHA2DS2-VASc, n (%)
1	5 (1.4)	5 (71.4)	0 (0)	0 (0)
2	13 (3.1)	2 (28.6)	11 (26.2)	0 (0)
3	77 (18.6)	0 (0)	25 (59.5)	52 (14.3)
4	96 (23.2)	0 (0)	6 (14.3)	90 (24.7)
5	79 (19.1)	0 (0)	0 (0)	79 (21.7)
6	88 (21.3)	0 (0)	0 (0)	88 (24.2)
7	40 (9.7)	0 (0)	0 (0)	40 (11.0)
8	14 (3.4)	0 (0)	0 (0)	14 (3.8)
9	1 (0.2)	0 (0)	0 (0)	1 (0.3)

Notes: CHADS₂, congestive heart failure, hypertension, age ≥75 years, type 2 DM, previous stroke (doubled); CHA₂DS₂-VASc, congestive heart failure, hypertension, age ≥75 years (two scores), type 2 DM, previous stroke, TIA, or TE (doubled), vascular disease, age 65–74 years, and sex category.

a Compared to patients with CHADS₂ score 0, P<0.05.

b CHA₂DS₂-VASc score ≥2 compared to patients with CHA₂DS₂-VASc score 1, P<0.05.

Abbreviations: DM, diabetes mellitus; TE, thromboembolism; TIA, transient ischemic attack.

Table 2 IS/TE risk of CHADS₂ components from Cox regression analyses

Variables	IS/TE risk
	HR (95% CI)	P-value
Cardiac failure	2.253 (1.240–4.092)	0.008
Hypertension	1.033 (0.537–1.989)	0.922
Age	1.038 (1.000–1.076)	0.047
DM	1.419 (0.801–2.517)	0.231
Previous stroke/TIA	2.555 (1.408–4.635)	0.002
CHADS2 score	1.438 (1.187–1.743)	0.000

Note: CHADS₂, congestive heart failure, hypertension, age ≥75 years, type 2 DM, previous stroke (doubled).

Abbreviations: DM, diabetes mellitus; HR, hazard ratio; IS, ischemic stroke; TE, thromboembolism; TIA, transient ischemic attack; CI, confidence interval.

Table 3 IS/TE risk of CHA₂DS₂-VASc components from Cox regression analyses

Variables	IS/TE risk
	HR (95% CI)	P-value
Cardiac failure	2.253 (1.240–4.092)	0.008
Hypertension	1.033 (0.537–1.989)	0.922
Age	1.038 (1.000–1.076)	0.047
DM	1.419 (0.801–2.517)	0.231
Previous stroke/TIA	2.555 (1.408–4.635)	0.002
Vascular disease	1.518 (0.832–2.771)	0.174
Previous MI	0.598 (0.323–1.108)	0.102
PAD	2.717 (1.395–5.294)	0.003
Female	1.067 (0.599–1.899)	0.826
CHA2DS2-VASc score	1.286 (1.086–1.523)	0.004

Note: CHA₂DS₂-VASc, congestive heart failure, hypertension, age ≥75 years (two scores), type 2 DM, previous stroke, TIA, or TE (doubled), vascular disease, age 65–74 years, and sex category.

Abbreviations: DM, diabetes mellitus; HR, hazard ratio; IS, ischemic stroke; MI, myocardial infarction; PAD, peripheral artery disease; TE, thromboembolism; TIA, transient ischemic attack; CI, confidence interval.

Figure 1 ROC curves of CHADS₂ and CHA₂DS₂-VASc scores in predicting IS/TE.

Notes: CHADS₂ < congestive heart failure, hypertension, age ≥75 years, type 2 DM, previous stroke (doubled); CHA₂DS₂-VASc, congestive heart failure, hypertension, age ≥75 years (two scores), type 2 DM, previous stroke, TIA, or TE (doubled), vascular disease, age 65–74 years, and sex category.
Abbreviations: DM, diabetes mellitus; IS, ischemic stroke; ROC, receiver operating characteristic; TE, thromboembolism; TIA, transient ischemic attack.

Figure 2 The Kaplan–Meier curve of freedom from ischemic stroke by CHADS₂ score.

Note: CHADS₂ < congestive heart failure, hypertension, age ≥75 years, type 2 DM, previous stroke (doubled).
Abbreviation: DM, diabetes mellitus.

Figure 3 Risk of IS/TE based on CHADS₂ scores.

Note: CHADS₂, congestive heart failure, hypertension, age ≥75 years, type 2 DM, previous stroke (doubled).
Abbreviations: DM, diabetes mellitus; IS, ischemic stroke; TE, thromboembolism; M–H, Mantel–Haenszel test.