Introduction: The 2 most commonly used risk scores to predict thromboembolic events in patients with atrial fibrillation - AF are the CHADS2 and the CHA2DS2-VASC tthat use Congestive Heart Failure, Hypertension, Age>75, Diabetes mellitus and previous Stroke or transient ischemic attack (TIA). The CHA2DS2-VASC score ADDS in addition Vascular disease, age>65 and female sex There is a controversy as to which score performs better in terms of risk prediction.
Aim:To compare and describe the predictive ability of these risk scores in a large contemporary cohort of patients with non-valvular atrial fibrillation in israel Methods:The Clalit Health Services (CHS) computerized database of 2,420,000 adults, includes data of community clinic visits, hospital discharge records ,medical diagnoses, medications , medical interventions and laboratory test results.During 2004-2012, 98,811 patients had nonvalvular AF. We assigned their risk scores and compared their predictive ability. Results: The distribution of risks is presented in figure 1. The rate of stroke and death (per 1000 person year) is shown based on risk category in figure 2. The presictibe ability of CHADS2 was somehat better and the predictive ability decreased when moving from the CHADS2 to CHA2DS2-VASC score by 14% for mortality and by 7% for stroke.
Conclusions: Both risk scores perform similarly but the CHADS2 performed somewhat better for ischemic stroke prediction and significantly better for prediction of mortality
