Validation of CHA2DS2 VASc Score Predictability of Stroke and Systemic Embolization in a Middle Eastern Population with AF: The Jordan Atrial Fibrillation (JoFib) Study

Figures & data

Table 1 Demographic Characteristics of Study Sample and Follow-Up Outcomes

	N	%
Sex
Male	925	45.8
Female	1095	54.2
Mean age	67.87 (18 to 106)
Age categories
<70	920	45.5
70–74.9	442	21.9
≥75	658	32.6
Co-morbidities
HTN	1506	74.6
DM	881	43.6
Heart failure	532	26.3
CKD	181	9
Dyslipidemia	909	45
Smoker	280	13.9
Hx stroke	310	15.3
Hx of systemic embolization	31	1.5
Ischemic heart dx	243	12
Sleep apnea	85	4.2
COPD	71	3.5
Lung fibrosis	11	0.5
Thyroid	202	10
Cancer	122	6
Medication use
Anti-platelet	904	44.8
Anticoagulant	1653	81.8
BMIcat
Normal	248	23.5
Overweight	522	35.5
Obesity	614	41.4
CHA2DSVASC score
0	84	4.2
1	195	9.7
2	290	14.4
3	387	19.2
4	430	21.3
5	338	16.7
6	188	9.3
7	78	3.9
8	25	1.2
9	5	0.2
Follow-up outcomes
NEW CVA	69	3.4
New SE	9	0.45
Major bleeding	63	3.1
Death any cause	276	13.7
Stroke or SE-related death	18	0.9

Table 2 Characteristics of Stroke Patients

	New Stroke or New SE	No New Stroke or New SE	P value
Age	72.8	67.68	0.000
Gender			0.815
Male	36(3.9%)	889(96.1%)
Females	40(3.7%)	1055(96.3%)
HTN	65(4.3%)	1441(95.7%)	0.023
DM	49(5.6%)	832(94.4%)	0.000
Smoking	6(2.1%)	274(97.9%)	0.173
Dyslipidemia	40(4.4%)	869(95.6%)	0.196
Use of anticoagulant	65(3.9%)	1588(96.1%)	0.451
Past stroke	24(7.7%)	286(92.3%)	0.000
BMI, kg/m^2			0.553
<25	13(3.8%)	331(96.2%)
≥25	53(4.5%)	1083(95.3%)

Table 3 Binary Logistic Regression Odd Ratio for Development of Stroke and SE

	OR	95% CI	p
Constant	0.024		0.0000
CHA2DVASC	3.100	1.761 to 5.457	0.0000
Dyslipidemia	1.055	0.639 to 1.742	0.833
Smoking	1.166	0.493 to 2.762	0.726
BMI	1.292	0.693 to 2.408	0.421
Anti-coagulant	1.09	0.509 to 2.334	0.825

Table 4 ROC Curve Results

ROC Curve CHAD2VASC Score and	Incidence of Stroke	Area Under the Curve	95% CI	P value	Best Cutoff to Give Best Sensitivity and Specificity
New stroke 3 months	16(0.8%)	0.557	0.413 to 0.701	0.431	–
New stroke 6 months	35(1.9%)	0.708	0.629 to 0.788	0.000	4
New stroke 6–12 months	24(1.4%)	0.722	0.638 to 0.806	0.000	4
Stroke in all follow-up periods	69(3.4%)	0.673	(0.615 to 0.732)	0.000	4
Systemic embolization (0–3)	2(0.1%)	0.743	0.513 to 0.974	0.234	-
SE 3–6 months	6(0.32%)	0.772	0.617 to 0.928	0.021	4
SE 6–12 months	1(0.1%)	0.918	0.872 to 0.965	0.184	-
SE all follow-up periods	9(0.45%)	0.774	0.653 to 0.895	0.004	4
SE or stroke all follow-up periods	76(3.76%)	0.689	0.634 to 0.744	0.000	4
Death all cause		0.698	0.666 to 0.730	0.000	4
Death from stroke		0.798	0.697 to 0.899	0.000	5
Males SE or stroke all follow-ups period	36(4.04%)	0.704	0.629 to 0.779	0.000	4
Death stroke		0.779	0.592 to 0.966	0.018	4
Death all cause		0.69	0.644 to 0.737	0.000	4
Females SE or stroke all follow-up periods	40(3.79%)	0.696	0.619 to 0.774	0.000	5
Death from stroke		0.8	0.68 to 0.92	0.000	5
Death all cause		0.729	0.688 to 0.77	0.000	5

Figure 1 ROC cure for CHAD2VASC score and development of stroke or SE at 1 year.