title: Predictive role of CHADS2 and CHA2DS2-VASc scores on stroke and thromboembolism in patients without atrial fibrillation: a meta-analysis.
abstract: CHA2DS2-VASc is the extension of the CHADS2 score developed by Birmingham 2009. This risk stratification schema is often used in clinical setting when considering additional risk factors for developing stroke in AF patients. However, its role in the non-AF population is unknown. This study was designed to evaluate the accuracy of the CHADS2 and the CHA2DS2-VASc scoring systems.
  
  
  
  Studies designed for CHADS2 and CHA2DS2-VASc score in stratifying the risks for stroke development in non-AF patients were included.
  
  
  
  Among the 114 studies identified, six trials were chosen finally and included for meta-analysis. The pooled diagnostic odds ratio (DOR) for CHADS2 and CHA2DS2-VASc was 2.86 (95% CI =1.83-4.28) and 2.80 (95% CI =1.83-4.28), respectively. CHA2DS2-VASc score was of better sensitivity than CHADS2 score (0.920 vs. 0.768). However, both scores were showed to have inherent heterogeneity and poor specificity.
  
  
  
  Though having good diagnostic accuracy, the clinical application of the CHADS2 and CHA2DS2-VASc scores in predicting risk of stroke development in non-AF patients still needs further validation. Key message The overall diagnostic accuracy of CHADS2 and CHA2DS2-VASc in stroke-risk stratification was good in patients with non-atrial fibrillation.
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Feng-Di
authors.initials: FD
authors.lastname: Liu
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Shen
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Rong
authors.initials: R
authors.lastname: Zhao
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Ge-Fei
authors.initials: GF
authors.lastname: Li
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Yi-Lan
authors.initials: YL
authors.lastname: Wu
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Tao
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.affiliation: b Department of Neurology , Xixi Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine , Hangzhou , China ;
authors.forename: Jia-Jun
authors.initials: JJ
authors.lastname: Zhou
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Bo
authors.initials: B
authors.lastname: Zheng
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Qi-Ting
authors.initials: QT
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Qian
authors.initials: Q
authors.lastname: Yao
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Wang
authors.affiliation: c Department of Neurology , Henan Provincial People's Hospital , Zhengzhou , China.
authors.forename: Hui-Qin
authors.initials: HQ
authors.lastname: Liu
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Liang
authors.initials: L
authors.lastname: Shu
authors.affiliation: a Department of Neurology , Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine , Shanghai , China ;
authors.forename: Jian-Ren
authors.initials: JR
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D003661:Decision Support Techniques; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment / Q000379:methods*; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology*
keywords: Atrial fibrillation; CHADS2; meta-analysis; stroke; thromboembolism