title: CHA2 DS2 VASc Score as a Predictor of Cardiovascular Events in Ambulatory Patients without Atrial Fibrillation.
abstract: BACKGROUND
  New evidence suggests that the CHA(2)DS(2)VASc (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 CHA(2)DS(2)VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA(2)DS(2)VASc 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, CHA(2)DS(2)VASc 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 person-years). We found significant differences in relation to gender, age, previous stroke, and follow-up length in patients with and without adverse outcomes. The CHA(2)DS(2)VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA(2)DS(2)VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27-13.90).
  
  
  CONCLUSIONS
  In our population, CHA(2)DS(2)VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF.
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Gustavo Freb
authors: GF
authors: Polenz
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Tiago Luiz Luz
authors: TL
authors: Leiria
authors: Cardiac Electrophysiology, McGill University Health Centre, Montreal, Québec, Canada.
authors: Vidal
authors: V
authors: Essebag
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Marcelo Lapa
authors: ML
authors: Kruse
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Leonardo Martins
authors: LM
authors: Pires
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Thaize Brisolara
authors: TB
authors: Nogueira
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Raphael Boesche
authors: RB
authors: Guimarães
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Roberto Tofani
authors: RT
authors: Santanna
authors: Electrophysiology Department of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Gustavo Glotz
authors: GG
authors: DE Lima
mesh_terms: D017677:Age Distribution; D000368:Aged; D000553:Ambulatory Care; D001281:Atrial Fibrillation; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D015897:Comorbidity; D016757:Death, Sudden, Cardiac; D048909:Diabetes Complications / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*; D015996:Survival Rate
keywords: CHA2DS2VASc; atrial fibrillation; cohort study; risk; stroke