CHA2DS2VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation.

Background: New evidence suggests that the CHA₂DS₂VASc (congestive heart failure, hypertension [HTN], age, diabetes, stroke, vascular disease, and female gender) score may be a reliable tool to predict the risk of thromboembolic events in patients without documented atrial fibrillation (AF). Methods: We performed a prospective cohort study of outpatients without AF or flutter, who were not using oral anticoagulation. Clinical characteristics were assessed and patients were stratified according to the CHA₂DS₂VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA₂DS₂VASc score during the follow-up. Results: Four hundred sixty-eight patients without AF were enrolled with a mean follow-up of 12 ± 6 months. Age was 64.9 ± 11.3 years. The prevalence of HTN was 88.4%, diabetes 37.6%, heart failure 26.3%, and vascular disease 61.7%. Overall, CHA₂DS₂VASc score was 3.4 ± 1.4. There were 15 major adverse cardiac outcomes during 12.2 months of follow-up (overall incidence of 3.2 per 100 personyears). We found significant differences in relation to gender, age, previous stroke, and follow-up length in patients with and without adverse outcomes. The CHA₂DS₂VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA₂DS₂VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27-13.90). Conclusions: In our population, CHA₂DS₂VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF. [ABSTRACT FROM AUTHOR]