title: Meta-analysis of ATRIA versus CHA2DS2-VASc for predicting stroke and thromboembolism in patients with atrial fibrillation.
abstract: BACKGROUND
  Several studies have compared the discriminative performances of CHA2DS2-VASc and ATRIA scores, but the results are still disputed. Therefore, we aimed to explore their predictive abilities regarding stroke and thromboembolism (TE) risk in AF patients.
  
  
  METHODS
  We systematically searched the Cochrane Library, PubMed and ScienceDirect databases up to May 2016 for studies regarding CHA2DS2-VASc and ATRIA scores. The data were extracted and then pooled using Review Manager software version 5.30.
  
  
  RESULTS
  Six cohort studies with 363,432 participants were included. Using the published cut-off points, the pooled C-statistics were 0.66 for ATRIA and 0.63 for CHA2DS2-VASc (Pdiff>0.05). Using the optimized cut-off points, the C-statistics were 0.66 for ATRIA and 0.65 for CHA2DS2-VASc (Pdiff>0.05). However, the ATRIA score presented a positive net reclassification improvement (NRI) value compared with the CHA2DS2-VASc score. In contrast, the CHA2DS2-VASc score classified fewer patients as low and moderate risk than the ATRIA score. The CHA2DS2-VASc score had lower event rates (either events per person or events per 100 person-years) in both the low and moderate risk categories compared with the ATRIA score.
  
  
  CONCLUSIONS
  In combination with C-statistics and NRI values, the ATRIA score performed better than the CHA2DS2-VASc score for stroke risk prediction. In contrast, the CHA2DS2-VASc score was superior to the ATRIA score for identifying truly "low risk" AF patients.
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Wengen
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Linghua
authors.initials: L
authors.lastname: Fu
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Zhenyan
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Jinzhu
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China; Jiangxi Key Laboratory of Molecular Medicine, Nanchang, Jiangxi 330006, China. Electronic address: hongkui88@163.com.
authors.forename: Kui
authors.initials: K
authors.lastname: Hong
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications*; D006305:Health Status Indicators; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*
keywords: ATRIA; Atrial fibrillation; CHA(2)DS(2)-VASc; Stroke; Thromboembolism