title: The CHA2DS2-VASc score as a predictor of high mortality in hospitalized heart failure patients.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is common in patients with heart failure (HF). CHA2DS2-VASc score was originally employed as a risk assessment tool for stroke in patients with AF; however, it has recently been used to predict not only stroke but also various cardiovascular diseases beyond the original AF field. We aimed to verify the CHA2DS2-VASc score as a risk assessment tool to predict mortality in patients with HF.
  
  
  RESULTS
  Consecutive 1011 patients admitted for treatment of HF were divided into three groups based on their CHA2DS2-VASc scores: score 1-3 group (n= 317), score 4-6 group (n= 549) and score 7-9 group (n= 145). Of the 1011 HF patients, 387 (38.3%) had AF. We compared patient characteristics among the three groups and prospectively followed for all-cause mortality. Although left ventricular ejection fraction was similar among all three groups, all-cause mortality was higher in the score 4-6 group and score 7-9 group than in the score 1-3 group (37.9 and 29.3% vs. 15.1%, log-rankP< 0.001). In the multivariable Cox proportional hazard analysis, the CHA2DS2-VASc score 7-9 was an independent predictor of all-cause mortality (all HF patients: hazard ratio (HR) 1.822,P= 0.011; HF patients with AF: HR 1.951,P= 0.031; HF patients without AF: HR 2.215,P= 0.033).
  
  
  CONCLUSIONS
  The CHA2DS2-VASc score was an independent predictor of all-cause mortality in HF patients with or without AF. This comprehensive risk assessment score may help identify HF patients who are at high risk for mortality in HF patient.
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Akiomi
authors.initials: A
authors.lastname: Yoshihisa
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kanno
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Takiguchi
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yokokawa
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Oikawa
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Shu-Ichi
authors.initials: SI
authors.lastname: Saitoh
authors.affiliation: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
keywords: Atrial fibrillation; CHA2DS2‐VASc score; Heart failure; Prognosis