Follow-up delta CHA2DS2-VASc score better predicts CVA in A-fib

(HealthDay)—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 in the Jan. 16 issue of the Journal of the American College of Cardiology.

Tze-Fan Chao, M.D., 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 percent of patients. The majority of the 4,103 patients who experienced ischemic stroke had a Delta CHA₂DS₂-VASc score ≥1 (89.4 percent, versus 54.6 percent in patients without ischemic stroke). Nearly two-thirds of patients who had an ischemic stroke (64.4 percent) had at least one 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.