HealthDay News — Assessing change in the CHA2DS2-VASc score over time is more predictive of ischemic stroke in patients with atrial fibrillation (AF) than the baseline score, according to a study published the Journal of the American College of Cardiology.
Tze-Fan Chao, MD, from the Taipei Veterans General Hospital in Taiwan, and colleagues compared the effectiveness of assessing ischemic stroke risk in 31,039 patients with AF using the CHA2DS2-VASc score, based on the baseline risk factors, and the Delta CHA2DS2-VASc score, which reflects the change in score between baseline and follow-up.
The researchers found that the CHA2DS2-VASc score remained unchanged in only 40.8% of patients. The majority of the 4103 patients who experienced ischemic stroke had a Delta CHA2DS2-VASc score ≥1 (89.4%, vs 54.6% in patients without ischemic stroke). Nearly two-thirds of patients who had an ischemic stroke (64.4%) had at least 1 new-onset comorbidity, most commonly hypertension. The Delta CHA2DS2-VASc score significantly better predicted ischemic stroke compared to baseline or follow-up CHA2DS2-VASc scores, based on the C-index and the net reclassification index.
“The Delta CHA2DS2-VASc score, reflecting the change in score between baseline and follow-up, was strongly predictive of ischemic stroke, reflecting how stroke risk in AF is a dynamic process due to increasing age and incident comorbidities,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Chao TF, Lip GYH, Liu CJ, et al. Relationship of aging and incident comorbidities to stroke risk in patients with atrial fibrillation. J Am Coll Cardiol. 2018;71(2):122-132.