title: Postoperative ischemic stroke and death prediction with CHA2DS2-VASc score in patients having coronary artery bypass grafting surgery: A nationwide cohort study.
abstract: OBJECTIVE
  This nationwide cohort study was attempted to address the predictive ability of CHA2DS2-VASc score in both ischemic stroke and death in patients undergoing coronary artery bypass grafting (CABG) surgery.
  
  
  METHODS
  We identified patients aged ≥18years undergoing de novo CABG between January 1, 2000 and December 31, 2011. We calculated CHA2DS2-VASc score for each study patient. We used univariable and multivariable Cox proportional hazards regression models to measure the hazard ratios (HRs) and 95% confidence intervals (CIs) for ischemic stroke and death associated with CHA2DS2-VASc score in the study patients. We used the area under the curve of receiver-operating characteristic (C-statistic) to calculate the predictive power of CHA2DS2-VASc score with respect to ischemic stroke and death in patients having CABG.
  
  
  RESULTS
  A total of 43,694 patients aged ≥18years receiving de novo CABG were included in the study cohort. The incidence and risk of ischemic stroke and death were positively associated with CHA2DS2-VASc score in patients receiving CABG. In addition, the discriminatory properties of the score resulted in C-statistics of 0.60 (95% CI=0.59-0.61) and 0.63 (95% CI=0.62-0.64) for the prediction of ischemic stroke and death in patients undergoing CABG, respectively.
  
  
  CONCLUSIONS
  The present study is the first nationwide cohort study to investigate the performance of CHA2DS2-VASc score for the prediction of ischemic stroke and death in patients receiving CABG. However, the discriminative power was modest, and the predictive role of CHA2DS2-VASc score in this population remained to be determined.
authors.affiliation: School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan; Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan. Electronic address: weisyunhu@gmail.com.
authors.forename: Wei-Syun
authors.initials: WS
authors.lastname: Hu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology
keywords: CHA(2)DS(2)-VASc score; Coronary artery bypass grafting; Death; Ischemic stroke