cha2ds2-vasc Score and Clinical Outcomes of Patients with Heart Failure

Background: Currently, there is no reliable and easy to use clinical score for risk stratification of patients with congestive heart failure. We aimed to evaluate the association between the CHA2DS2-VASc score and adverse clinical outcomes of ambulatory heart failure patients.

Methods: Included were patients with congestive heart failure who have been treated in the outpatient heart failure clinic at the Meir Medical center between 2011-2017. Patients were classified into 3 groups according to the CHA2DS2-VASc score: 0-2 (low), 3-4 (intermediate),

Results: The 1,138 patients had a mean age 71.9±13 years and included 62% males. Of them, 153 (13%) had low, 433 (38%) intermediate and 552 (49%) high CHA2DS2-VASc score. Considering the patients with low CHA2DS2-VASc score as the reference group yielded adjusted odds ratios for all-cause death that increased in an independent graded association (OR=3.1, 95%CI=2.0-4.8, OR=5.2, 95%CI=3.3-7.9, for patients with intermediate and high score, respectively, p<0.001). A higher CHA2DS2-VASc score was also associated with significantly higher risk for heart failure hospitalizations: 1.8 (95% CI 1.2-2.6, p<0.01) and 2.9 (95% CI 1.9-4.2, p<0.01) for intermediate and high CHA2DS2-VASc scores, respectively. Each 1-point increase in CHA2DS2-VASc score was associated with 35% and 25% increased risk for all-cause mortality and hospital admission for heart failure.

Conclusion: The CHA2DS2-VASc score correlates with adverse clinical outcomes of patients with congestive heart failure and may be considered for risk stratification in this high-risk population.