title: The CHADS2 score is a useful predictor of coronary arteriosclerosis on 320 slice CT and may correlate with prognosis in subjects with atrial fibrillation.
abstract: OBJECTIVE
  In evaluating coronary arteries by 64-256 slice CT, atrial fibrillation (AF) is usually an exclusion criterion. We used CHADS2 score to predict coronary arteriosclerosis estimated by 320-slice CT and prognosis in AF subjects.
  
  
  METHODS
  A total of 183 consecutive subjects (148 male; 64.1 ± 11.1 years, 97 hypertension, 60 hyperlipidemia, 21 diabetes mellitus, 76 smoking habits, body mass index 23.4 ± 3.5) who were diagnosed previously as chronic (N=104) or paroxysmal AF (N=79), and who underwent electrocardiogram-gated 320-slice CT were enrolled. The composite end point of cardiac death or sudden death was assessed.
  
  
  RESULTS
  A total of 183 AF subjects were divided into 3 groups: CHADS2 scores of 0 (N=53), 1 (N=57) and ≥2 (N=73). Frequency of the presence of calcified plaque, non-calcified plaque, mixed plaque, any plaque, and >50% stenosis and Agatston calcium score was significantly lower in CHADS2 score 0 group compared with score 1 or score ≥ 2 groups. In logistic-regression models for prediction of calcified plaque, or any plaque on CT, the odds ratios of CHADS2 score ≥ 2 group to CHADS2 score 0 or 1 group were 2.03 and 2.12, respectively (both P<0.05). During a median of 19.2 months, the composite-event-rate was significantly higher in subjects with CHADS2 score ≥ 2 than those with CHADS2 score 0 (P=0.049) in Kaplan-Meier survival analysis.
  
  
  CONCLUSIONS
  The CHADS2 score is a useful predictor of coronary arteriosclerosis on CT and may correlate with prognosis in AF subjects. Subjects with high CHADS2 score should be examined for coronary arteriosclerosis in addition to cerebral infarction.
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan. Electronic address: nobusada@w8.dion.ne.jp.
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takaoka
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Koya
authors.initials: K
authors.lastname: Ozawa
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging*; D055424:Cardiac-Gated Imaging Techniques; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: 320 slice computed tomography; Chronic and paroxysmal atrial fibrillation; Coronary arteriosclerosis; Prognosis; The CHADS2 score