CHADS2 versus CHA2DS2-VASc scoring systems for predicting prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation

Objective To assess the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Methods Consecutive ischemic stroke patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after stroke were registered and 206 patients with nonvalvular atrial fibrillation were enrolled in this study. Patients were divided into 3 groups on the basis of CHADS2 scores (0, 1, 2 to 6) and CHA2DS2-VASc score (0, 1, 2 to 9). And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS≤2 reflected good prognosis and mRS≥5 implicated unfavorable outcome). After screening the risk factors affecting prognosis using univariate analysis, the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis was estimated using Logistic regression model. Results The proportion of high-risk group was significantly higher (P<0.01) while that of low-risk group significantly lower as stratified by CHA2DS2-VASc score than by CHADS2 scores (P<0.01). Logistic regression model results suggested that CHA2DS2-VASc score was an independent predictor of good prognosis and unfavorable outcome. CHADS2≥2, and CHA2DS2-VASc≥2 were all correlated with prognosis, but multivariate logistic analysis identified only CHA2DS2-VASc≥2 as the independent risk factor for prognosis (OR=3.24, 95%CI: 1.32-6.98, P=0.00). Conclusions The average score of CHA2DS2-VASc is higher than that of CHADS2 and has better predictive ability for prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Key words: Atrial fibrillation; Stroke; CHADS2 score; CHA2DS2-VASc score; Aged