title: Prevalence of atrial fibrillation in patients with high CHADS2- and CHA2DS2VASc-scores: anticoagulate or monitor high-risk patients?
abstract: BACKGROUND
  In patients with known atrial fibrillation (AF) different scores are utilized to estimate the risk of thromboembolic events and guide oral anticoagulation. Diagnosis of AF strongly depends on the duration of electrocardiogram monitoring. The aim of this study was to use established scores to predict the prevalence of AF.
  
  
  METHODS
  The CHADS2- (Congestive Heart failure, hypertension, Age >75 years, Diabetes, Stroke [doubled]) and CHA2DS2VASc-score (Congestive Heart failure, hypertension, Age ≥75 years [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74 years, Sex category [female sex]) was calculated in 150,408 consecutive patients, referred to the University Hospital of Rostock between 2007 and 2012. All factors constituting these scores and a history of AF were prospectively documented with the ICD-10 admission codes.
  
  
  RESULTS
  Mean age of our study population was 67.6 ± 13.6 years with a mean CHADS2-score of 1.65 ± 0.92 and CHA2DS2VASc-score of 3.04 ± 1.42. AF was prevalent in 15.9% of the participants. The prevalence of AF increased significantly with every CHADS2- and CHA2DS2VASc-score point up to 54.2% in CHADS2-score of 6 and 71.4% in CHA2DS2VASc-score of 9 (P < 0.001).
  
  
  CONCLUSIONS
  The prevalence of AF increases with increasing CHADS2- and CHA2DS2VASc-score. In intermediate scores intensified monitoring may be recommended. In high scores, thromboembolic complications occurred irrespective of the presence of AF and anticoagulant therapy may be initiated irrespective of documented AF.
authors.forename: Tina s
authors.initials: Ts
authors.lastname: Tischer
authors.forename: Ralph
authors.initials: R
authors.lastname: Schneider
authors.forename: Jörg
authors.initials: J
authors.lastname: Lauschke
authors.forename: Catharina
authors.initials: C
authors.lastname: Nesselmann
authors.forename: Anke
authors.initials: A
authors.lastname: Klemm
authors.forename: Doreen
authors.initials: D
authors.lastname: Diedrich
authors.forename: Günther
authors.initials: G
authors.lastname: Kundt
authors.forename: Dietmar
authors.initials: D
authors.lastname: Bänsch
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D020521:Stroke / Q000150:complications; D014652:Vascular Diseases / Q000150:complications
chemical_list: D000925:Anticoagulants