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Yeungnam Univ J Med > Volume 33(1); 2016 > Article
Yeungnam University Journal of Medicine 2016;33(1):8-12.
DOI: https://doi.org/10.12701/yujm.2016.33.1.8    Published online June 30, 2016.
The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients.
Jae Hoon Kwak, Se Hwan Yeo, Yeo Un Kim, Jin Suk Lee, Byong Kyu Kim, Jin Wook Chung, Jun Ho Bae, Deuk Young Nah, Kwan Lee
1Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.
2Division of Cardiology, Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea. ptca@dongguk.ac.kr
3Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea.
Abstract
BACKGROUND: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. METHODS: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. RESULTS: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. CONCLUSION: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.
Key Words: Atrial fibrillation, Stroke, Anticoagulation
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